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Innovations to improve
the public’s health
Thinking Big
SPRING 2 0 1 0
volume 1 · number 8
Dennis Gillings, CBE, PhD, Chair
Chairman and Chief Executive Officer
Quintiles
Marcia A. Angle, MD, MPH
Adjunct Professor
Nicholas School of the Environment
Duke University
William K. Atkinson, PhD, MPH
President and Chief Executive Officer
WakeMed
Joseph Carsanaro, MBA, MSEE
General Manager
Pinehurst Advisors LLC
Gail H. Cassell, PhD, DSc (hon)
Vice President, Scientific Affairs and
Distinguished Lilly Research Scholar
for Infectious Diseases
Eli Lilly and Company
Willard Cates Jr., MD, MPH
President, Research
Family Health International
Susanne Glen Moulton, JD, MPH,
President
Director
Patient Assistance and Reimbursement
Programs
GlaxoSmithKline
Jack E. Wilson, PE, MSENV,
Vice President
Board of Directors
TEC Incorporated
Delton Atkinson, MPH, MPH, PMP
Deputy Director
Division of Vital Statistics, National
Center for Health Statistics
Centers for Disease Control and
Prevention
David J. Ballard, MD, MSPH, PhD,
FACP
Senior Vice President and Chief Quality
Officer
Baylor Health Care System
Executive Director and BHCS Endowed
Chair
Institute for Health Care Research and
Improvement
Andrea Bazán, MPH, MSW
President
Triangle Community Foundation
Fred T. Brown Jr., MPH, FACHE
Managing Director
Business Development
Carolinas HealthCare System
Kelly B. Browning, MA
Executive Vice President
American Institute for Cancer Research
Deniese M. Chaney, MPH
Partner
Accenture Health and Life Sciences
Andrew Conrad, PhD
Chief Scientific Officer
National Genetics Institute
Keith Crisco, MBA
Secretary of Commerce
State of North Carolina
Nancy A. Dreyer, PhD, MPH
Chief of Scientific Affairs
OUTCOME
Ken Eudy
Chief Executive Officer
Capstrat
Robert J. Greczyn Jr., MPH
Chief Executive Officer Emeritus
BlueCross and BlueShield of North
Carolina
James R. Hendricks Jr., MS
Vice President of Environment, Health
and Safety (Retired)
Duke Energy
Stacy-Ann Christian, JD, MPH
Senior Director
Research Administration
New York City Health and Hospital
Corporation
Michael (Trey) A. Crabb III, MHA,
MBA
Managing Principal - Nashville
Stroudwater Associates
Leah Devlin, DDS, MPH
Gillings Visiting Professor
UNC Gillings School of Global Public
Health
Carolina Public Health Solutions
Cynthia J. Girman, DrPH
Senior Director
Department of Epidemiology
Merck Research Laboratories
Sandra W. Green, MBA, MHA,
BSPH
President, East Coast Customer
Management Group
MedAssets Incorporated
C. David Hardison, PhD
Corporate Vice President
Life Sciences
Science Applications International
Corporation
Deborah Parham Hopson, PhD,
RN
Assistant Surgeon General
Associate Administrator
HIV/AIDS Bureau
Health Resources and Services
Administration
J. Douglas Holladay, MDiv
Chairman and Chief Executive Officer
PathNorth
Donald A. Holzworth, MS
Chairman
Futures Group International
David P. King
President and Chief Executive Officer
Laboratory Corporation of America
A. Dennis McBride, MD, MPH
Health Director
City of Milford (Conn.)
John McConnell
Chief Executive Officer
McConnell Golf
Guy Miller, MD, PhD
Chairman and Chief Executive Officer
Edison Pharmaceuticals Incorporated
James Patrick O’Connell, PhD, MPH
Chief Executive Officer
Acea Biosciences Incorporated
Joan C. Huntley, PhD, MPH
Adjunct Professor of Epidemiology
UNC Gillings School of Global Public
Health
Mark H. Merrill, MSPH
President and Chief Executive Officer
Valley Health System
Stephen A. Morse, MSPH, PhD
Associate Director for Environmental
Microbiology
National Center for the Prevention,
Detection, and Control of Infectious
Diseases
Centers for Disease Control and
Prevention
Douglas M. Owen, PE, BCEE
Vice President
Malcolm Pirnie Incorporated
Jonathan J. Pullin, MS
President and Chief Executive Officer
The Environmental Group of the
Carolinas Inc.
Roy J. Ramthun, MSPH
President
HSA Consulting Services LLC
Jacky Ann Rosati, PhD
Environmental Scientist and
Containment Area Lead
U.S. Environmental Protection
Agency
National Homeland Security
Research Center
Ilene C. Siegler, PhD, MPH
Professor of Medical Psychology
Duke University
Carmen Hooker Odom, MS
President
Milbank Memorial Fund
Jane Smith Patterson
Executive Director
The e-NC Authority
Joan Siefert Rose, MPH
President
Council for Entrepreneurial
Development
Virginia B. Sall
Co-Founder and Director
Sall Family Foundation
Charles A. Sanders, MD
Chairman and Chief Executive Officer
(Retired)
Glaxo Incorporated
Paul M. Wiles, MHA
President and Chief Executive Officer
Novant Health Incorporated
Jeffrey B. Smith, MHA, CPA
Partner
Ernst & Young LLP
Paula Brown Stafford, MPH
Executive Vice President
Integrated Clinical Services
Quintiles Transnational Corporation
Russell B. Toal, MPH
Clinical Associate Professor
Health Policy and Management
Jiann-Ping Hsu College of Public
Health
Georgia Southern University
John C. Triplett, MD, MPH
Regional Medical Officer
Bethesda, Md.
G. Robert Weedon, DVM, MPH
Veterinary Outreach Coordinator
Alliance for Rabies Control
Adjunct Faculty
UNC-Wilmington
Veterinarian
New Hanover County (N.C.) Board
of Health
Alice D. White, PhD
Vice President
Worldwide Epidemiology Department
GlaxoSmithKline
Thomas K. Wong, PhD
Vice President
Meganium Corporation
Public Health Foundation, Incorporated BOARD OF DIRECTORS
UNC Gillings School of Global Public Health ADVISORY COUNCIL
c a r o l i n a p u b l i c h e a l t h | 1
contents spring 2010
3 Innovation matters!
4 Bright ideas, right partners, insightful solutions
6 No sugar-coating the crusade against obesity
9 Flu viruses move fast—so do public health officials
10 Going Viral
11 Harnessing vast data to understand COPD
13 ‘Team Science’ advances technology
14 UNC and UAE partner to protect environment
16 Peers for Progress
17 Water power—bringing streams together to make a mighty river
18 How the World Learns
20 Tracking Tropical Disease
21 Converting hog waste into energy
23 Unraveling the mystery of arsenic’s modi operandi
features & news
continued 8
4
6
17
11
21
2 | SPRING 2 0 1 0
24 Safety first on the job, especially for
inexperienced teens
25 Putting new ideas where their mouths are
26 school news
29 in memoriam
30 awards and recognitions
33 New cervical cancer initiative aims to save lives
33 Allison composes song to celebrate School
34 Senkomago selected for Tellus Educational
Foundation Scholarship program
35 Sanofi-aventis to sponsor new Department of
Nutrition scholarship program
35 biOS turns 60!
36 One generous turn inspires another
Delton atkinson, mph: champion of diversity
contents, continued 29
spring 2010 Dean
Barbara K. Rimer, DrPH
director of communications
managing editor
Ramona DuBose
editor
Linda Kastleman
Associate Dean for
External Affairs
Peggy Dean Glenn
Design and Production
Karen Hibbert
UNC Design Services
Contributing Writers
Jay Cartwright, Ramona DuBose,
Natalie Gott, Linda Kastleman,
Kathleen Kearns, Chris Perry, Susan
Shackelford and Angela Spivey
illustrations
Karen Hibbert
Articles appearing in Carolina
Public Health may be reprinted with
permission from the editor. Send
correspondence to Editor, Carolina
Public Health, Gillings School of
Global Public Health, Campus Box
7400, Chapel Hill, NC 27599-7400, or
e-mail sphcomm@listserv.unc.edu.
Subscribe to
Carolina Public Health
www.sph.unc.edu/cph
17,000 copies of this document were
printed at a cost of $11,397 or $0.67
per copy.
Carolina Public Health (ISSN 1938-
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UNC Gillings School of Global Public
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Chapel Hill, Chapel Hill, NC 27599-
7400. Vol. 1, No. 8, Spring 2010.
our donors
24 25
back page
c a r o l i n a p u b l i c h e a l t h | 3
Innovation refers both to some new thing—a prod-uct,
program or idea thought to be an improvement
over what preceded it—and a process of getting the
thing into practice. In public health, especially in our
School, we aim to solve some of the world’s greatest
problems—providing safe water to people who lack
it, helping to change unhealthy behaviors, such as
smoking and poor diets, reducing errors in operating
rooms and pharmacies, and developing better ways
to conduct clinical trials. Too many interventions are
cumbersome, costly or culturally inappropriate. We
need practical, practicable and scalable innovations
that are transformative. Some inspiring examples
from our School include:
• Mark Sobsey, PhD, and colleagues designed a
much improved ceramic water filter. A crucial
test is its adoption on a scale large enough to
make a difference.
• Repellent-treated mosquito bed nets are an
important innovation. Faculty members,
including Drs. Frieda Behets, Andrea Biddle,
Steve Meshnick, Audrey Pettifor and Annelies
Van Rie, conduct field studies to ensure that
nets are adopted in practice.
• Noel Brewer, PhD, and Jennifer Smith, PhD, are
among the first to study how new vaccines to
prevent HPV are being adopted.
• The Safe Dates program, developed by Vangie
Foshee, PhD, and colleagues, is more effective
than previous programs; it now is being used
around the country.
• Deborah Tate, PhD, was one of the first to take
dietary counseling online.
• Marci Campbell, PhD, was awarded an NIH
Challenge Grant for her novel use of micro-finance
and health behavior interventions to
improve diets in eastern North Carolina.
• Sue Havala Hobbs, DrPH, and Ned Brooks,
DrPH, created a new hybrid-model executive
Doctor of Public Health program that allows stu-dents
to keep working while earning a doctorate.
We have funded 18 Gillings Innovation Labo-ratories
to solve big public health problems and
accelerate solutions. The range of programs, from
development of new laboratory tests to new ways of
encouraging use of local foods, is impressive.
Many innovations are worthy of adoption. Yet,
we know that the process of adopting public health
innovation is painfully slow; people die waiting. Sev-eral
faculty members, including Alice Ammerman,
DrPH, Cathy Melvin, PhD, and Bryan Weiner, PhD,
focus on speeding adoption of innovations.
Our faculty, staff, students and partners are
creating ideas, programs, tests and tools to improve
the public’s health and translate effective programs
into practice. Together, we bring life to public health
“innovation.” It’s a matter of health!
Innovation Matters!
UNC Chancellor Holden Thorp wants Carolina to be an innovation hub. As
leader of a great public university and a scientist known for chemistry inventions,
Thorp understands that innovations play a critical role in improving health and
society. In this issue of Carolina Public Health, we investigate innovation’s role in
our School and its broader implications for public health.
Dr. Barbara K. Rimer
from the Dean’s desk
To him who devotes his life to science,
nothing can give more happiness than
increasing the number of discoveries, but his
cup of joy is full when the results of his studies
immediately find practical applications.
–Louis Pasteur
L isa Marie Albert
Note: Rimer also participates in a roundtable discussion about innovation on pages 4–5.
4 | SPRING 2 0 1 0
Bright ideas,
right partners,
insightful solutions
In this century, public health researchers
could discover more advances—preventives
for cancers, new ways to heal and protect
the environment, effective means to prevent
obesity and more efficient ways to provide
health care for all.
“Innovation in public health brings hope
to all humankind—hope that our children
and our children's children will live healthier,
higher-quality lives without much of the suf-fering
that seems so prevalent in our world
today,” says Dennis Gillings, CBE, PhD, chair
and chief executive officer of Quintiles and
chair of the School’s Advisory Council.
Innovation is fundamental at the UNC
Gillings School of Global Public Health. This
issue of Carolina Public Health is dedicated to
the outstanding efforts of faculty, students,
staff and alumni who are searching for more
effective vaccines for tougher diseases (see
page 10), finding better ways to provide
clean water throughout the world (see page
17), waging war against obesity (see page 6),
and fighting pollution, cancer and infectious
diseases.
In January 2010, members of the UNC-Chapel
Hill Chancellor’s Innovation Circle
visited the School to hear about some of our
researchers’ innovative solutions to water
problems facing the world. The circle is an
advisory council of respected UNC alumni
and friends charged with helping to develop
a roadmap for a culture of systematic
innovation and entrepreneurship
at Carolina. It is chaired by
Lowry Caudill, PhD, a 1979
UNC graduate and co-founder
of Magellan Laboratories Inc. After
the visit, Caudill said he and other circle
members were impressed with research being
done at the School.
“Chancellor Thorp’s vision is to transform
new knowledge in the university for maxi-mum
societal benefit,” Caudill said. “The
(Gillings) School of (Global) Public Health is
doing this already and doing it really, really
well. I made the point later in the afternoon
to the whole group that as we look for best
practices at other schools like Stanford and
MIT, we need to look in our own backyard
at the School of Public Health.”
So what is innovation?
“Innovation is all about creating things,”
said Don Holzworth, chair of Futures Group
International and the School’s Gillings
Executive in Residence. “It’s about joining
ideas that haven’t been joined before, which
Vaccines for diseases such as polio and smallpox,
fluoridation of drinking water, prenatal care and
use of vitamin A to prevent blindness all are public
health innovations. So are seat belt laws, clean drink-ing
water, modern sanitation requirements and cam-paigns
against abuse of drugs, alcohol and tobacco.
f e at u r e s a n d n ews
ultimately leads to a breakthrough or a more
efficient way of delivering something we
already know about.”
Innovation often comes when people with
different perspectives join forces to solve a
problem.
“The ‘outsider’s perspective’ can stimulate
new ideas,” Holzworth said. “It’s disruptive
thinking, but it’s constructive disruption.”
The UNC Gillings School of Global Public
Health is partnering with different depart-ments,
universities, government agencies
(domestic and foreign), nongovernmental
organizations, companies and individuals.
For example, UNC biostatistics researchers
now work with researchers at Duke and N.C.
State universities to find ways to design more
powerful clinical trials for cancer treatments.
Their work is funded through a $12.5 million
grant from the National Cancer Institute
(see page 26). UNC public health research-ers
also have teamed up with officials and
academicians in the United Arab Emirates
and with Rand Corporation and others to
assess environmental and public health risks
accelerated by development and to establish
a national strategy for addressing those risks
(see page 14).
“Because everyone’s resources are so lim-ited,
it’s more important now than ever
before to be creative and work with partners
we’ve never worked with before,” said Leah
Devlin, DDS, Gillings Visiting Professor and
former North Carolina state health director.
Devlin lauds the School’s efforts, espe-cially
through the N.C. Institute for Public
Health (NCIPH), to work with the state’s
Department of Health and Human Services
and with local health departments through-out
North Carolina.
“We are the only state in the country that
requires accreditation of our health depart-ments
to establish consistent standards,”
she said.
Jane Smith Patterson, executive director of
e-NC Authority and member of the School’s
Advisory Council, echoes Devlin’s enthusi-asm
for how the state and the university can
enhance each other’s work.
“By matching public health needs with
the knowledge of university public health
researchers and public health practitioners,
there is an amazing opportunity to develop
innovative programs and practices that can
be…taken to scale in close to real time,”
she said.
But not every innovation is an improve-ment,
cautions Barbara K. Rimer, DrPH,
dean and Alumni Distinguished Professor
at the School.
“In 2005, for example, biostatistics profes-sor
Ed Davis, PhD, and others found that new
medicines to treat schizophrenia were not
better than their predecessors, cost more and
caused more side effects,” she said.
“This comparative effectiveness research
is essential. We must know when newer is
not better.”
Innovations are more than inventions,
Rimer said.
“We care about innovations because in
public health, and especially in our School,
we aim to solve some of the world’s greatest
problems. We must be willing to look at how
we have done things before and ask whether
there are other, better ways to do a thing. We
want to create the ideas, programs, tests and
tools that make the world better. Those are
public health products, and they are happen-ing
right here, at our School.”
And they’re making a difference.
“Public health investment and dedication
by our university are making the difference
and will continue to do so,” Gillings said.
“Moreover, prevention promises huge
breakthroughs, particularly if we can impact
selective behavior patterns in cost-effective
ways. I am excited about our opportunity and
applaud our dedicated researchers for their
motivation and devotion to improving the
health of us all.”
–Ramona DuBose
Innovation is all about creating things …
It’s about joining ideas that haven’t been
joined before, which ultimately leads to a
breakthrough or a more efficient way of
delivering something we already know about.
–Don Holzworth
c a r o l i n a p u b l i c h e a l t h | 5
6 | SPRING 2 0 1 0
f e at u r e s a n d n ews
But Popkin, an internationally recognized
expert in nutrition and obesity, is unfazed.
Savvy, passionate and eager to speak out,
he says, “I want to have an impact.”
The Carla Smith Chamblee Distinguished
Professor of Global Nutrition in the Uni-versity
of North Carolina’s Gillings School
of Global Public Health and director of
the UNC interdisciplinary obesity program
makes an impact often.
You may have seen his comments in The
New York Times or Time magazine or heard
him on National Public Radio or Al Jazeera.
He’s such a seasoned media source that he
might show up for a satellite inter-view
at the UNC television stu-dios
in a shirt and tie—and shorts
and sandals. He knows he’ll be
visible only from the waist up.
Now 66, Popkin was among
the first researchers to start track-ing
the effects of diet and activ-ity.
His data are based on four
decades of observation of indi-viduals,
households and com-munities,
from Russia to Mexico
and China to Brazil. The worst
problems used to be hunger and
malnourishment. Now, obesity is
epidemic in both developed and
developing countries.
He says sugar-sweetened beverages are to
blame for much of the weight gain. “You are
what you drink,” he says. In 1960, the aver-age
American consumed 100 to 200 calories
a day in beverages. Today, the figure is 500
calories.
In 2005, Popkin assembled leading nutri-tion
experts from Johns Hopkins, Harvard,
Louisiana State and Oregon State universi-ties,
and other institutions, to study available
literature and provide guidance on risks and
benefits of various beverage categories. Their
results were published in The American Jour-nal
of Clinical Nutrition in 2006.
“The Beverage Guidance Panel that Barry
convened produced a first of its kind—a
guide for the kinds of beverages that have the
best value for your health,” says George Bray,
MD, Boyd Professor and chief of the division
of clinical obesity and metabolism at the
Pennington Biomedical Research Center in
Baton Rouge, La., and a member of the panel.
Now, Popkin works with governments
around the world to establish beverage guide-line
policies.
“France and the U.K. have banned caloric
beverages in schools,” he says. “Mexico has
created beverage guidelines, and now I am
working with the U.K. and China on this topic.”
In the U.S., he advocates a tax on sugar-sweetened
beverages to discourage people
from drinking them, he says. He and six
other scholars wrote a 2009 report in The
New England Journal of Medicine that advo-cated
a consumer tax of one percent per
No sugar-coating the
crusade against obesity
When Barry Popkin, PhD, advocates for a
national tax on sugar-sweetened beverages,
soft-drink makers and food-industry groups attack.
“Everybody comes after me,” he says.
All Ages
Percentage of daily caloric intake from beverage, by age group
0
5
10
15
20
% 25
Age 2-18 19-39 40-59 60+
Other milk beverages
Coffee and tea
Alcohol
Fruit juice
Milk
Fruit drinks
Soft drinks
c a r o l i n a p u b l i c h e a l t h | 7
ounce on sugar-sweetened beverages both
to reduce consumption and bring in money
to support health programs, as tobacco taxes
have done. His latest study, published March
9, 2010, in Archives of Internal Medicine,
shows that people eat less fast food, such as
pizza and burgers, when the prices go up,
supporting his proposal to tax these foods
in addition to sugar-sweetened beverages.
Not surprisingly, soft-drink makers,
supermarket companies, the fast-food indus-try
and other groups poured more than $24
million into the coffers of Washington lobby-ists
in the first nine months of 2009 to fight a
potential national tax and other regulations,
according to The Huffington Post.
Popkin’s recent book, The World is Fat:
The Fads, Trends, Policies and Products that
are Fattening the Human Race, draws on what
he’s learned throughout his
career. He makes a strong
case that lifestyle changes,
including eating more sug-ary
and fatty foods, as well
as government policies and
globalized food marketing,
are fueling the weight gain.
“How we eat, drink and
move has changed so drasti-cally
in the last 60 years,” he
says. “Our biology clashes
with modern marketing and
technology.”
His research exam-ines
health implications of
those policies and lifestyle
changes, and his findings
have been published in more
than 300 articles in peer-reviewed
journals, including
The New England Journal of
Medicine, Journal of the American Medical
Association, Science, Obesity, Circulation and
the American Journal of Clinical Nutrition.
His research covers the whole spectrum of
life—for example, he’s published articles
in both Pediatrics and the Journal of Nutri-tion
of the Elderly. His work has appeared
in renowned peer-reviewed publications in
Europe, China, the Philippines and the Asia-
Pacific region.
His most innovative work, say colleagues,
has been developing the concept of “Nutri-tion
Transition,” a way of understanding
long-term nutritional status changes by look-ing
at shifts in the stages of eating, drinking
and activity, underlying societal shifts and
resulting effects on body composition.
He also has pioneered large longitudinal
studies around the world, including ones in
China, Russia and the Philippines. He’s led
related studies in Brazil, Mexico and other
countries, studying some populations for
four decades. “When I came into the field,
such studies were not a focus,” he says.
His work has played a major role in estab-lishing
databases for scholars to study diet
and activity. More than 10,000 researchers
have downloaded his longitudinal studies.
Dr. Barry Popkin takes personally his professional campaign for good health,
regularly biking to campus for exercise. (Note: Popkin removed his helmet to
pose for the photo, but he never bikes without it.)
Popkin says sugar-sweetened beverages are
to blame for much of the weight gain.
“You are what you drink.”
8
l inda kastleman
f e at u r e s a n d n ews
8 | SPRING 2 0 1 0
“Barry has made many important con-tributions
to nutrition research,” says Penny
Gordon-Larsen, PhD, UNC associate profes-sor
of nutrition, who has published several
articles with Popkin. “He is probably most well
known for his work on the nutrition transi-tion
and global obesity. Yet he also has made
major contributions in investigations on the
role of dietary fat in obesity, sugar-sweetened
beverages and obesity, health disparities, and
economic determinants of diet and obesity.”
Popkin—tall, wiry and agile—attacks
obesity many different ways. On a personal
level, he rides his bike to work and around
town. He is part of an international board
of scientists helping to develop simple front-of-
the-package labels in European countries,
Israel and India. He’s working with the
Mexican Ministry of Health and Finance to
develop a similar program in that country.
He also has waded into the U.S. Food and
Drug Administration’s review of nutrition
labeling guidelines. In the Feb. 8 issue of The
New York Times, he wrote: “Placing compli-cated
labeling on the back of the package simply
does not work. Studies from the Netherlands,
the U.S. and elsewhere have found that system
to be confusing and that it does little to affect
consumer decisions. Front-of-the-package
labeling, which has emerged in the past three
to four years, promises to be more effective.”
But he doesn’t stop there.
“We also need to remove all false advertis-ing
that says ‘contains antioxidants’ and tries
to connote that a product is ‘heart healthy’
when there is no reality to that claim,” he
writes. “We need ways to stop food manufac-turers
from making misleading claims, and
we need scientists independent of the food
industry to set healthy guidelines for various
food categories.”
No wonder he’s a target.
However, he also tries to reach out to the
food and beverage industry, encouraging
them to be part of the solution to obesity. In
2007, he started an annual “Global Obesity
Business Forum” with senior executives
from food, beverage and infant formula
companies. The meetings are private, Popkin
says, so the executives can be frank and open
about their concerns and processes.
As a college student in the 1960s, Popkin
was active in the civil rights movement nation-ally
and in his home state of Wisconsin. Those
experiences, he said, taught him to take the
slings and arrows of criticism in stride. “There
were people who loved you, and people who
hated you,” Popkin says. “That’s the way it is
when you’re fighting for a cause.” n
–Susan Shackelford
SWEETENED
BEVERAGES
[20 oz.]
SWEETENED
BEVERAGES WITH
NO CALORIES [5 oz.]
LOW FAT
MILK [3 oz.]
SWEETENED
BEVERAGES WITH
NUTRIENTS [15 oz.]
TEA/COFFEE
UNSWEETENED [15 oz.]
WATER
[46 oz.]
FLUID OUNCES
Total = 104
SWEETENED
BEVERAGES
[20 oz.]
SWEETENED
BEVERAGES WITH
NO CALORIES [5 oz.]
LOW FAT
MILK [3 oz.]
SWEETENED
BEVERAGES WITH
NUTRIENTS [15 oz.]
TEA/COFFEE
UNSWEETENED [15 oz.]
WATER
[46 oz.]
SWEETENED
BEVERAGES
[211 calories]
SWEETENED
BEVERAGES WITH
NO CALORIES [1 cal.]
TEA/COFFEE
UNSWEETENED [11 cal.]
WATER [0 calories]
CALORIES
Total = 464
SWEETENED
BEVERAGES WITH
SOME NUTRIENTS
[213 calories]
LOW FAT MILK [29 calories]
FLUID OUNCES
Total = 104
Americans drink too much and drink unhealthily.
These figures show the beverage intake pattern
of adults in the U.S., in volume and calories.
Drinking 35 oz. of sweetened beverages in a
day (out of a total 104 oz.) accounts for about
half of the calories consumed from beverages.
Popkin’s Beverage Panel suggests the average
adult might best consume 98 oz. in beverage
each day, including up to 50 oz. of water and no
sweetened beverage without nutrients.
Dr. Barry Popkin is a frequent guest at Carolina News Studio, giving interviews that are
broadcast around the world.
l inda kastleman
c a r o l i n a p u b l i c h e a l t h | 9
They wanted to determine what people knew
about the vaccine and how many were plan-ning
to get immunized. And they needed to
know fast.
They found help at the N.C. Center for
Public Health Preparedness at UNC Gill-ings
School of Global Public Health’s N.C.
Institute for Public Health. Jennifer Horney,
PhD, research assistant professor of epide-miology
and deputy director at the center,
partnered with UNC public health school
alumnus Aaron Fleischauer, PhD, a com-mander
with the U.S. Public Health Service
stationed at the N.C. Department of Health
and Human Services in Raleigh, to launch a
rapid research project.
“For any preparedness effort, we want to
understand how the community perceives
the public health crisis so we can respond
better,” Fleischauer says.
In this case, telephone interviews weren’t
sufficient. Twenty percent of people in
the U.S. have replaced land lines with
cell phones, and one of the groups at
highest risk for the H1N1 virus—
people aged 18 to 25 years—are
among those most likely to be
missed by a traditional phone sur-vey.
The team decided to conduct
in-person interviews, choosing a
two-stage random sample that employed the
use of parcel maps and geographic informa-tion
systems.
“Interviewers use a hand-held computer
with a GPS navigational tool that gives them
a map and printed directions that send them
to a random point. Then they go to the house
that’s nearest that point and conduct an
interview,” Horney explains.
A team of 20—including state personnel,
UNC faculty members and student volun-teers—
conducted 207 interviews with people
aged 18 to 92 from two North Carolina coun-ties,
Orange and Alamance. The population-based
sampling method yielded interviews
that would be representative of all the people
who live in those counties, Horney says.
The study showed that, at least in these
counties, people may not have been receiv-ing
the state’s communications about H1N1,
which were mostly online. Only a third of the
people in the study said they typically
found news and information on the
Internet, while 83 percent depended
upon television.
“It was a big surprise to us that
most people (in these counties) were
still getting news from television,
and even printed newspapers, which
were the second most common source
of information,” Horney says. Also, most
people in the survey were unaware that the
vaccine would be given in two doses, which
was the plan at the time of the survey.
These findings helped the state create bet-ter
and more targeted messages.
“Once we learned there were pieces of
information that the community wasn’t
getting, we made special efforts to get it to
them,” Fleischauer says.
The study also showed a greater-than-expected
potential demand for the vaccine,
with 63 percent of respondents saying they
planned to get vaccinated. The one previous
study regarding H1N1 perceptions—a national
Internet survey from Rand Corporation—had
showed that only 50 percent of people planned
to do so. If time and funds are available,
Horney aims to follow up in spring 2010, to
find out what percentage of North Carolinians
got vaccinated. n
–Angela Spivey
The N.C. Center for Public Health Preparedness is
part of a national network of preparedness centers
funded by the Centers for Disease Control and
Prevention (CDC). The study was funded by the
Robert Wood Johnson Foundation, and results
were published in the Dec. 25, 2009, edition of the
CDC’s Morbidity and Mortality Weekly Report
(MMWR). See http://snipurl.com/mmwr-flu.
Flu viruses move fast—
so do public health officials
preparing for pandemic
In August 2009, two months before the first
shipment of H1N1 vaccine was to arrive in North
Carolina, officials with the N.C. Division of Public
Health already were planning how to distribute it. Dr. Jennifer Horney
wil l owens
f e at u r e s a n d n ews
10 | SPRING 2 0 1 0
After all, he’s the epidemiology professor
who synthetically reproduced the variant
of the SARS virus found in bats—probably
the species from which the deadly human
version emerged.
“Only three other teams of researchers
have synthetically reconstructed a virus,” he
said when his research was published in the
Proceedings of the National Academy of Sci-ence.
“It will provide a model to understand
the means and ease by which animal corona-viruses
move from one species to another.”
Baric and his team of researchers at UNC
Gillings School of Global Public Health are
world leaders in coronavirus research. This
type of RNA virus is responsible not only for
SARS but also for other types of childhood
pneumonia and even the common cold.
“The lab has rewired the coronavirus
genome—taking out the natural regulatory
signals and rewiring them with synthetic
signals,” explains Eric Donaldson, PhD,
research assistant professor of epidemiology.
“This prevents the rewired virus from
recombining with natural strains of the virus
and prevents reversion of vaccine strains
into more dangerous strains. However, the
rewired virus still causes a similar immune
response in the body.”
Baric and his team were awarded a Gill-ings
Innovation Lab (GIL) to develop a low-cost,
single-dose vaccine against respiratory
illness in children living in develop-ing
countries. This vaccine would
treat influenza, RSV and measles;
be stable at room temperature; and
inhaled, rather than given with a
needle. If they are successful, their
work could lead to a new approach
for designing and administering
other global health vaccines.
“No one has ever successfully
delivered three antigens from three
different highly pathogenic respiratory
viruses simultaneously in a highly portable
platform that would be affordable and easy to
use in the developing world,” Baric said after
receiving his GIL.
Any of these three projects—the synthetic
reproduction of SARS, the genetic rewir-ing
of coronavirus or the multivalent vac-cine—
could yield astounding stories about
innovation. But Baric wanted to focus on yet
another innovative project.
“Let’s talk about norovirus,��� he suggested.
Noroviruses are those nasty little bugs
that cause great misery—48 to 72 hours of
vomiting and/or diarrhea in healthy adults. In
infants and the elderly, the virus can be fatal.
“It only takes a few virus particles from
respiratory droplets or fecal contamination
to cause explosive transmission of the disease,
especially in isolated communities,” he said.
In communities such as retirement homes,
college dormitories, military installations,
cruise ships and even airplanes, the infection
can have devastating results.
People can acquire norovirus infections
more than once in a season.
“It’s been thought that the body’s immune
response to norovirus infection is short-lived,
and that’s why people become reinfected,”
Baric said. “We don’t believe that this rep-resents
the whole story. We think the virus
is changing rapidly, so the body’s immune
Going viral
From SARS to the common cold,
Baric’s research could lead to vaccines
An issue of Carolina Public Health on innovation
would be incomplete without an article on
Ralph Baric, PhD, and his work with viruses.
Lisa Lindesmith, an epidemiology
research specialist at the School,
studies norovirus immunity in Dr.
Ralph Baric’s laboratory.
ramona dubose
system doesn’t recognize the new strain.”
The change is known as “antigenic
drift.” Immunity a person might have built
up to one variation of the virus is powerless
against the next strain. But Baric hopes
that by finding common elements of the
viruses’ genetic structure—and then caus-ing
the body to build immunity to those
elements—he can create a vaccine effective
against about 95 percent of the norovirus
strains that infect humans.
“His work, although still with mice, has
shown there is a way to develop effective
vaccines against these viruses, even though
you have to cover quite a few genetic types,”
said Jan Vinjé, PhD, norovirus team leader
in the Gastroenteritis and Respiratory
Viruses Laboratory Branch of the U.S. Cen-ters
for Disease Control and Prevention.
“[Baric] brings a fresh, new perspective
to the field,” Vinjé said.
Lisa Lindesmith, an epidemiology
research specialist who’s been working
with Baric for 10 years, agrees.
“We are moving the field from the idea
of short-term immunity. This is ground-breaking
work, and so is the coronavirus
work. It’s very rare for a lab to be so good
at two different things.” n
–Ramona DuBose
Dr. Ralph Baric’s innovative work with
viruses may lead to a portable, single-dose
vaccine to prevent respiratory illness
in children in developing countries.
ramona dubose
How do you capture and organize the infor-mation
a study like that generates? How do
you analyze all that complex data to make
it useful to those searching for treatments?
Through the groundbreaking methods of
UNC’s Collaborative Studies Coordinating
Center—that’s how.
Lisa LaVange, PhD, director of the CSCC
and professor of bio-statistics
at the UNC
Gillings School of
Global Public Health,
leads data collection
and analysis effort for
a project called SPI-ROMICS,
a nation-wide
study that aims
to help the more than
12 million people with chronic obstructive
pulmonary disease (COPD), a progressive
condition that makes breathing difficult.
SPIROMICS is short for SubPopulations
and InteRmediate Outcome Measures in
COPD Study. That mouthful of a moniker
indicates the project’s two goals: to identify
and better understand the various kinds
of COPD—known types include chronic
bronchitis and emphysema—and to discover
quicker ways to measure whether new treat-ments
will work. LaVange and her team won
a seven-year, $8 million contract from the
National Institutes of Health’s National Heart,
Lung and Blood Institute to serve as SPI-ROMICS’
Genomics and Informatics Center.
“It’s a real pan-campus research project,”
says LaVange. She believes the award came
to UNC because of its reputation for state-of-
the-art approaches to biostatistics, data
management and pulmonary research.
The Genomics and Informatics
Harnessing vast data to
understand COPD and
speed up new treatments
Ten clinics in six study centers. Thousands of
patients who suffer from a disease that has
multiple variations. Three years’ worth of clinical
and molecular data for each patient.
Dr. Lisa LaVange
8
c a r o l i n a p u b l i c h e a l t h | 11
12 | SPRING 2 0 1 0
f e at u r e s a n d n ews
Center draws together the expertise of Rich-ard
Boucher, MD, Claire Doerschuk, MD,
and Wanda O’Neal, PhD, at the UNC School
of Medicine; Jane Greenberg, PhD, and Javed
Mostafa, PhD, at the School of Information
and Library Science; and Fred Wright, PhD,
and Wei Sun, PhD, at the UNC Gillings
School of Global Public Health’s Department
of Biostatistics, where CSCC is based. The
CSCC team includes programmers, statisti-cians,
clinical monitors and project assistants
and is led by CSCC faculty member David
Couper, PhD, and project manager Betsy
Carretta. A fifth-generation, state-of-the-art
data management system, recently upgraded
to enhance data security and implement
industry-wide data standards, will be used
for the massive amounts of data to be col-lected
as part of the project.
Chronic obstructive pulmonary disease
is the fourth leading cause of death in the
United States, and currently no drugs bring
about long-term improvement. Study cen-ters
in Winston-Salem, N.C., Ann Arbor,
Mich., San Francisco, Los Angeles, New
York City and Salt Lake City will conduct
a wide range of clinical testing, collect bio-logical
specimens, and take both baseline
and follow-up radiological scans of more
than 3,200 patients.
“The fun comes when we start putting
clinical, radiological, molecular and biologi-cal
variables together,” says LaVange.
LaVange’s team will test specific hypoth-eses
about new subgroups of COPD patients.
“Not all people are affected by all forms of
COPD in the same way,” she explains.
“If we better understand the subtypes
of the disease, we can better target
patients for enrollment in clinical tri-als
designed to investigate a particular
therapeutic agent.”
The team also will identify biological,
clinical and radiological markers that
indicate how severe a patient’s disease is and
potentially can provide a sense of whether a
therapeutic agent is working or not. Clinical
trials to test new pharmaceuticals can take
years to complete, LaVange points out. Find-ing
markers that predict long-term outcomes
in a shorter period of time can accelerate the
development process and, combined with
more targeted patient enrollment, has the
potential to improve the chance of success in
future COPD clinical trials. n
–Kathleen Kearns
The fun comes when we start putting
clinical, radiological, molecular and
biological variables together.
At left, Dr. Richard Boucher examines a lung
tissue sample while Drs. Claire Doerschuk
and Wanda O’Neal look on. At right,
Doerschuk presents information about the
effect of chronic obstructive pulmonary
disease (COPD) on the human lung.
Project manager Betsy Carretta,
MPH (foreground), reviews materials
with SPIROMICS team members
including Dr. Patricia Basta (right),
co-director of the Biospecimen
Processing and Storage facility.
photos by l inda kastleman
l inda kastleman
c a r o l i n a p u b l i c h e a l t h | 13
What’s the right dose of a given drug? So
far, agencies charged with answering these
questions—the U.S. Environmental Protec-tion
Agency and Food and Drug Adminis-tration—
have not had good ways to account
for an immutable fact about human beings—
namely, that people are different.
Individual genetic makeup might keep
one person from metabolizing a given sub-stance,
while another might metabolize so
much that it becomes toxic. Ivan Rusyn, MD,
PhD, associate professor of environmental
sciences and engineering at UNC Gillings
School of Global Public Health and director
of the Carolina Center for Computational
Toxicology (CCCT), leads several projects
developing breakthrough methods to con-sider
genetic diversity. Research by Rusyn
and colleagues provides substantive data to
determine safe levels for pharmaceuticals
and environmental chemicals.
“Rapid advances in the technology of
genotyping make these types of studies pos-sible,”
Rusyn explains.
“Five or ten years ago, it was a major
undertaking to sequence one individual
mouse, yeast or human.”
Now, he says, researchers can quickly and
inexpensively sequence genetic information.
That means genetic data on many individuals
can be obtained easily.
It also means dealing with a staggering
amount of information.
“For some research, where we screen thou-sands
of compounds on hundreds of people,
we have millions of data points,” he says.
That’s where computational toxicology
comes in. The interdisciplinary field merges
toxicology, biology and computer science
to create new ways to synthesize data and
predict chemical hazards.
“Toxicologists need biostatisticians,
geneticists and molecular biologists to be
part of the team,” Rusyn says. “It’s team sci-ence,
and this campus is just great for build-ing
these teams.”
Fred Wright, PhD, professor of biostatis-tics,
is a key contributor to several research
efforts underway at CCCT. “Without his
help, we’d be dead in the water,” Rusyn says.
The teams don’t work on human popula-tions
per se, but on collections of human cells
from different individuals or on populations
of laboratory animals, such as mice.
“We’re using cell lines and exposing them
to different chemicals,” Rusyn says.
“We’re looking at whether different cell
lines respond differently, and if so, why. Simi-lar
experiments can be done in animal mod-els—
for example, in mice where we know the
genetic makeup of a particular strain. Having
in vitro and computational tools allows us to
address these risks without doing lengthy and
unnecessary animal research.”
The center’s col-laborative
approach
includes partnerships
with the EPA and the
National Institutes
of Health’s National
Institute of Environ-mental
Health Sci-ences,
National Toxicology Program and
National Chemical Genomics Center.
“We work with government stakeholders
to engage them in our research and leverage
resources and expertise,” Rusyn says.
Through this collaboration, he aims to
find reliable models to predict how individu-als
will react to chemicals and drugs. Rusyn
hopes that working directly with govern-ment
agencies also will speed up the flow of
information from the laboratory bench to the
regulator’s desk. n
–Kathleen Kearns
‘Team Science’
advances technology
Computational toxicology creates
new ways to synthesize data
How much exposure to a
certain chemical is safe?
Collaborative experiments with the National
Chemical Genomics Center are vital in gen-erating
data for Dr. Ivan Rusyn’s research.
Master’s student Shannon O’Shea (above, left)
and research specialist Oksana Kosyk traveled
to the center to expose dozens of cell lines
to various environmental chemicals, using the
center’s advanced robotic equipment (right).
Dr. Ivan Rusyn
photos by dr. menghang xia and sri sakamuru
14 | SPRING 2 0 1 0
Since June 2008, researchers at UNC Gill-ings
School of Global Public Health have
collaborated with UAE officials in an effort
to reduce and prevent such health challenges.
The UNC-UAE National Strategy for
Environmental Health project, sponsored by
the Environment Agency-Abu Dhabi, called
for UNC researchers to assess the country’s
greatest environmental risks and develop a
plan to strengthen the UAE’s public health
policy. UNC has partnered in that effort with
UAE University’s Department of Community
Medicine and with the RAND Corporation, a
global public policy research institution.
Researchers evaluated everything from
water quality, to food safety, to global climate
change. They found that outdoor air pollution
is the top environmental threat to the country,
followed by indoor air pollution and occu-pational
exposures. (Read the UAE project
report at www.sph.unc.edu/uae/report.)
Now, UNC epidemiologists are collecting
data to determine the effects that indoor pollut-ants,
diet and lifestyle have on Emiratis’ health.
The project is an opportunity to help UAE
officials manage environmental problems and
set the future course of environmental protec-tion,
said principal investigator Jacqueline
MacDonald Gibson, PhD, assistant professor
of environmental sciences and engineering.
It also serves as a bridge to rebuilding rela-tionships
in the Middle East, she said.
“After September 11 (2001), so much dam-age
was done to the relationship between the
U.S. and the Middle East that I thought we
needed to grab hold of this opportunity to
do constructive work in the Middle East,”
MacDonald Gibson said.
Ranking the risks
Once UNC researchers identified public
health threats facing the UAE, the next step
was to prioritize the needs for action. Com-mon
environmental risks do not always make
headlines, but they may be the biggest threat
facing a nation, MacDonald Gibson said.
Researchers worked with about 75 UAE
stakeholders to determine environmental
risk priorities.
UAE government officials, scholars and
representatives from industry and nongov-ernment
organizations participated in work-shops
to rank their priorities. Information on
each risk was provided in uniform summaries
that included details such as the fatalities the
risk was expected to cause in one year.
“Many of (the stakeholders) had never expe-rienced
a group process like that, and they felt
empowered that they had a chance to influence
their policy,” MacDonald Gibson said.
The project marked the first time this
process has been used on a national scale
to rank environmental risks. It has not
been employed in the United States because
policy here often is drafted after a disaster,
MacDonald Gibson said. However, the Army
Corps of Engineers is using the process to
assess risks along the Gulf Coast.
f e at u r e s a n d n ews
UNC and UAE
partner to protect
the environment
Rapid development in the United Arab
Emirates (UAE) has led to increased life
expectancy and greater economic opportunity, but
it also brings the potential for significant environ-mental
and public health threats.
Dr. Jacqueline MacDonald Gibson (right)
confers with colleague Rugaya Mohamed,
from the Environment Agency-Abu Dhabi.
Dr. pete andrews
The project marked the first time this process has been
used on a national scale to rank environmental risks.
Read the UAE project report at www.sph.unc.edu/uae/report.
c a r o l i n a p u b l i c h e a l t h | 15
Outdoor air quality
Outdoor air pollution is easily the greatest
threat to the 4.8 million people who live in
the UAE. UNC researchers estimate that 600
deaths each year can be attributed to outdoor
air pollution, with 540 of those due to par-ticulate
matter. Particulates include sand,
which can carry microbial fungi and other
infections, and result from diesel engines
used for massive construction, oil and gas
production, and car and barge traffic. Pol-lution
from Europe and Eastern Asia also
blows into the region.
To determine the UAE’s risk from outdoor
air pollution, scientists developed one of the
first air quality models in the region to simu-late
the atmosphere. The model stretched
beyond the UAE to the Arabian Peninsula
as far east as India, north into Turkey and
west to Cairo.
“We made the first state-of-the-art air
quality model for that part of the world,
and we created it using the most advanced
scientific methods and techniques available,”
said Will Vizuete, PhD, assistant professor of
environmental sciences and engineering, who
worked on the UAE outdoor air quality team.
With the model’s design, scientists at the
public health school have created the infra-structure
to track pollutants plaguing the
UAE, a critical step for making policy deci-sions
to reduce emissions.
Researchers now are drafting recommen-dations
on how to improve the country’s
ambient air-monitoring stations and design-ing
a study to measure more precisely the
pollutants in the air.
Epidemiology study
The UAE-UNC Indoor Air, Health and
Nutrition study is evaluating the air Emiratis
breathe inside their homes, the food they eat
and their general health and lifestyle pat-terns.
The assessment will be done in 600
homes across the seven emirates.
The UNC team of 20 faculty and staff
members are coordinating the study and
working with faculty members from the
United Arab Emirates University, who have
hired more than 50 field interviewers to visit
study participants’ homes.
On their first home visits, field interview-ers
set up air monitors and make a list of
the home’s residents. Interviewers return
seven days later to remove monitors and
interview participants about their health his-tories,
diets and lifestyles
(e.g., whether they smoke
or have recently exercised).
Field interviewers record
interview responses into
a computer program that
has been translated into
Arabic. Our public health
school’s Collaborative
Studies Coordinating Cen-ter
(CSCC) developed the
program and will analyze responses, says C.
Edward Davis, PhD, research professor in the
Department of Biostatistics.
The air monitors measure seven pollutants,
including nitrogen dioxide, carbon monoxide,
sulfur dioxide and particulate matter. Par-ticulate
matter is of special concern because
increased exposure to fine and coarse particles
is related to increased cardiovascular and respi-ratory
disease exacerbations and outcomes.
To monitor for these particles, research-ers
use an innovative device called a UNC
passive aerosol sampler. The instrument was
developed by UNC alumnus Jeff Wagner,
PhD, when he was a graduate student in
environmental sciences and engineering,
and David Leith, ScD, professor and associate
chair of the department.
The goal of the study is to provide useful
information about potential health effects
of indoor air pollutants and determine the
general health and nutrition status of Emi-ratis,
said Karin Yeatts, PhD, the study’s
co-principal investigator and research assis-tant
professor of epidemiology. The project
principal investigator is Andy Olshan, PhD,
chair of the department.
“I hope that the study findings will help
the Environment Agency-Abu Dhabi with
their air quality regulations,” Yeatts said,
“either to strengthen the regulations or verify
that what they currently have is useful for
protecting the public’s health.” n
–Natalie Gott
Researchers evaluated everything from water quality,
to food safety, to global climate change. They
found that outdoor air pollution is the top
environmental threat to the country, followed by
indoor air pollution and occupational exposures.
Playing outdoors usually is
a healthy activity, but out-door
air quality in the UAE
threatens the country’s 4.8
million people, especially
children and the elderly.
Dr. Will Vizuete Dr. Karin Yeatts
Ti ina Fol ley
16 | SPRING 2 0 1 0
f e at u r e s a n d n ews
A community health worker
in rural Arizona provides sup-port
and education to medically
underserved migrant workers
and new immigrants with dia-betes.
He helps order glucom-eters
and visits the workers if
they are sick.
Peers for Progress, a pro-gram
led by Edwin Fisher, PhD,
professor of health behavior and health
education at UNC Gillings School of Global
Public Health, is working to ensure that more
people living with diabetes or other chronic
health conditions have access to similar peer-support
networks.
Ongoing support from others who are
coping with similar difficulties can offer
emotional, social and practical assistance
that will help people become healthy.
“Unless they are very sick, people with
diabetes probably spend fewer than six
hours each year in a health professional’s
office,” Fisher says. “That leaves 8,760 hours
each year they are ‘on their own.’
Peer support can help people take
the plans they make in the doctor’s
office and put them into practice in
their daily lives. They get their ques-tions
answered and stay motivated to
sustain healthy patterns across those
8,760 hours.”
The American Academy of Family
Physicians Foundation established
Peers for Progress in 2006. Recognizing
UNC’s pre-eminence in community and
peer approaches to health promotion, the
group asked Fisher and colleagues to host
its Program Development Center a year later.
Faculty members, students and research staff
from the public health school’s health behav-ior
and health education department and
UNC’s School of Medicine guide the Center.
With initial funding from Eli Lilly and
Company Foundation, Peers for Progress has
focused on the global diabetes epidemic, pro-jected
to grow to 439 million people by 2030.
To accelerate best practices for peer support
around the world, Peers for Progress aims
to expand the proof that such programs are
beneficial. It collects information about the
many available programs, so as to secure rec-ognition
and resources for peer support as a
core component of prevention and health care.
“The niche of Peers for Progress is to net-work
with organizations around the world
to facilitate more programs, better-quality
programs and more secure support so the
programs can help as many people as pos-sible,”
Fisher said.
UNC Gillings School of Global Public
Health has a long tradition of providing
peer support in local communities. Current
faculty including Eugenia Eng, DrPH, and Jo
Anne Earp, ScD, professor and chair, respec-tively,
in the Department of Health Behavior
and Health Education, and Alice Ammer-man,
DrPH, and Marci Campbell, PhD, pro-fessors
of nutrition, have been involved in a
number of projects that empower individuals
through individual and group peer support. n
–Natalie Gott
Peers for Progress:
A peer educator in Cambodia conducts weekly group
sessions, offering lessons about diabetes manage-ment
and advice about physical activity and nutrition.
Learn more about Peers for Progress
at www.peersforprogress.org.
For information about MoPoTsyo, a non-governmental
peer-support program in
Cambodia, visit www.mopotsyo.org/
peereducation.html.
For information about Campesinos Diabetes
Management Program, a peer-support group
in Arizona, visit www.diabetesinitiative.org/
programs/DICSF.html.
Peers for Progress’ executive board met in February 2009 to honor Dr. Jose Caro (front, center)
who, as an executive at Eli Lilly and Company, conceived of the initial plan for Peers for Progress.
The board includes UNC public health faculty members Drs. Jo Anne Earp, Ed Fisher, Laura
Linnan and Deborah Tate.
Fisher heads global group
providing diabetes support
Tom Fuldner
Dr. Edwin Fisher
c a r o l i n a p u b l i c h e a l t h | 17
Across the United States, municipalities
use UNC-developed techniques to iden-tify,
remove and preclude the formation of
“disinfection byproducts” from drinking
water. These contaminants are created when
chlorine and other chemicals used to purify
drinking water mix with substances in water.
In eastern North Carolina, cities and
towns have water-sharing and other water
resource management agreements, devel-oped
with the assistance of UNC water
experts, which make the most of scarce water
resources and limited public budgets. The
agreements are in effect not only in rural,
“down-east” communities but also in the
Research Triangle area, home to some of the
state’s largest cities.
Since the 1920s, when H.G. Baity began
teaching sanitary engineering at the Uni-versity
of North Carolina, UNC has been a
leader where water and health intersect. From
locating the purest sources to developing tech-nologies
that keep drinking water safe, UNC
faculty members and students are innovators.
Into this powerhouse now comes Jamie
Bartram, PhD. For more than 30 years,
Bartram has analyzed and advanced connec-tions
between the environment and health
around the world. He comes to UNC from
the World Health Organization, where he
was coordinator for assessing and managing
environmental risks to health.
In July 2009, he joined the environmental
sciences and engineering faculty at the UNC
Gillings School of Global Public Health,
where his mission, through the establishment
of a new Water Institute at UNC, is to bring
together the many streams of water exper-tise
within the School and university and
incorporate them into one powerful river of
research, teaching and service with partners
throughout the state, nation and world.
“This School has an amazing track record
of success at the junction between public
health and water and sanitation,” Bartram
said. “We’re at a point now where draw-ing
together and focusing our strengths
with those of our partners will enable us to
make an even greater impact. The complex
problems of today and tomorrow demand
interdisciplinary responses. Our vision is to
break the boundaries that constrain prob-lem-
solving by bringing together disciplines
and sectors to confront some of humankind's
most critical challenges, whether at the local,
national or global level.”
Philip Singer, PhD, UNC’s Dan Okun
Distinguished Professor of Environmen-tal
Engineering, has contributed greatly to
the strength of UNC’s reputation in water
research. In 2006, he received the National
Water Research Institute’s acclaimed Clarke
Prize for excellence.
“UNC has a world-class reputation in
water resources, drinking water research
and sanitation,” Singer said. “We have a lot of
students and faculty doing work on a variety
of subjects involving drinking water and
public health, but it’s not a cohesive effort.
If we can bring everybody together under
a single umbrella, we’ll be more effective in
our efforts, generating more research fund-ing
and providing more valuable outreach.”
Bartram, Singer said, is the right person to
coordinate and focus such efforts.
“Jamie is an exceptional individual,” Singer
said. “He’s known by almost everybody in the
world in the water and sanitation field. He’s
creative, he’s thoughtful, he’s a visionary. And
at the same time, he’s very down-to-earth and
likeable. I’m excited about what the future
holds for our School and our University.” n
–Ramona DuBose
Water power—
bringing streams together to make a mighty river
In Cambodia, UNC students and faculty
members show people who’ve never had clean
water how to use ceramic filters in their homes.
The lifesaving potential is immense and immediate.
“The complex
problems of
today and
tomorrow demand
interdisciplinary
responses,” says
Dr. Jamie Bartram.
Universit y of Surrey
18 | SPRING 2 0 1 0
Thanks to innovations such as social network-ing,
micro-blogs and instantaneously loaded
video, we can know about an event within
moments of its happening, even if it happens
on the other side of the world.
These dramatic advances in technology—
and our increasingly easy and economical
access to it—affect the ways we learn. For
educators trying to stay one step ahead of
GoogleTM, the challenges may seem to equal
the potential. However, there is no longer a
question of whether technology is essential
to a teacher’s toolkit. It is.
Innovative programs based in UNC Gillings
School of Global Public Health’s Department of
Health Policy and Management and its Public
Health Leadership Program are on the front
lines of educating 21st-century learners.
“The rise of new technologies
poses both profound challenges
and opportunities for educators,”
says William Zelman, PhD, pro-fessor
of health policy and man-agement.
“The teaching-learning
hierarchy is quickly changing
from an emphasis on teaching
to an emphasis on learning—and
how to incorporate technology
into the process.”
“Millennial” students—those
born between 1977 and 1995—
are the focus of Zelman’s new
Gillings Innovation Laboratory.
His “Teaching and Training in
Public Health for the 21st Cen-tury:
Toward a Global Seamless
Classroom” examines issues related to cur-ricula
and engaging students in learning
activities.
“Many millennials are multi-taskers,” Zel-man
says. “They use the Internet for a variety
of tasks, including for texting, e-mailing and
participating in social media, many times
a day. They demand activities that engage
them, and incorporating information tech-nologies
is now an important part of cur-ricular
design.”
Along with others, Zelman has developed
a budgeting module designed to increase the
financial literacy of budding public health
practitioners.
The need for accessible and high-quality
public health education has increased expo-nentially
with the global increase in public
health priorities.
“Current distance learning practices
don’t address the needs of public health
practitioners around the world,” says Rohit
Ramaswamy, PhD, Gillings Visiting Associ-ate
Professor in the Public Health Leadership
Program. “Many of the working public health
professionals in developing countries have
not had access to technology or information
about best practices.”
Ramaswamy’s pilot program, “Leveraging
Local Knowledge to Improve Public Health,”
New methods and technologies transform the teacher’s role in global education
The ways we access and use information have
changed radically over the last decade.
Dr. Rohit Ramaswamy (left) meets with research assistant
Kate Barker, MPH, and Dr. Hollie Pavlica.
How the world learns
l inda kastleman
f e at u r e s a n d n ews
l inda kastleman
c a r o l i n a p u b l i c h e a l t h | 19
is based on a series of collaborations. To
develop the distance learning course for
global public health competencies, he has
worked with School faculty members Wil-liam
Sollecito, DrPH, Diane Calleson, PhD,
and Louise Winstanly, LLB, MS, of the Public
Health Leadership Program, who teach, and
Eugenia Eng, DrPH, Allan Steckler, DrPH,
and Laura Linnan, PhD, of the Department
of Health Behavior and Health Education,
who designed the curriculum.
Public health professionals in six learn-ing
units—three in Ethiopia and one each
in India, South Sudan and Swaziland—have
taken part in the pilot program. The units
include people who work together routinely
and face similar public health challenges.
“Our School has developed expertise in
educating degree-program students in col-laboration
and knowledge sharing,” Ramas-wamy
says. “Although program participation
does not result in an academic certificate
or degree, the practice of public health is
improved globally through participants’
common understanding of best practices.”
Another distance-learning endeavor, the
Public Health Leadership Program’s new
online Certificate in Global
Health, offers formal academic
certification. Developed in part-nership
with the School’s Office
of Global Health with Fogarty
International Center American
Recovery and Reinvestment Act
(ARRA) funds and a grant from
the UNC General Administra-tion,
the certificate program
includes courses in critical global
health issues, ethics, infectious
disease epidemiology, and moni-toring
and evaluation.
Like the innovative programs mentioned
above, this new certificate program uses
a collaborative learning approach so that
global leaders and health practitioners can
share knowledge with fellow program par-ticipants.
As students live around the world,
their experiences also will enrich the course.
“The Public Health Leadership Program has
a long history of success in online leadership
education,” says Hollie Pavlica, DrPH, clinical
assistant professor in the program, “and we
are uniquely positioned to meet the challenges
faced by health leaders around the world.”
James Porto, PhD, clinical assistant pro-fessor
and director of executive programs in
health policy and management, teaches a class
that tracks health care reform
legislation. Students’ research,
observations, questions and
interactive Tweets are collected
on a blog site, http://hpm755unc.
wordpress.com, which serves as
a news aggregator for the class.
“Ninety-five percent of man-agement
is decision making
and problem solving,” Porto
says. “This format (which
involves students analyzing
health care proposals and hav-ing
their analyses critiqued)
lends itself well to public health
issues students will face in the
real world.”
“It’s essential,” Porto says,
“to be able to organize infor-mation.
I see my role as that of
a navigator through the many
available resources.”
The Executive Doctoral Program in Health
Leadership, based in the Department of Health
Policy and Management, prepares mid-career
professionals for senior-level positions in orga-nizations
working around the world to improve
the public's health. The three-year, cohort-based
distance program confers a Doctor of
Public Health in health administration.
Students interact with faculty members
and peers primarily online, using technol-ogy
that supports live video, audio and data
sharing.
One of the pinnacles of the School’s online
global health efforts occurred in the execu-tive
leadership program on Jan. 21, 2010. The
first international online dissertation pro-posal
was defended successfully. It involved
a student from Lebanon, faculty members
from American University and St. Joseph’s
University in Beirut, a faculty member in
Paris, and two faculty members in Chapel
Hill (Edward “Ned” Brooks, DrPH, and John
Paul, PhD, clinical associate professors of
health policy and management).
The world moves fast, but it’s getting
smaller every day. n
–Linda Kastleman
• Read more about Zelman’s Gillings Innovation Lab
at www.sph.unc.edu/accelerate/gils/zelman.
• Read more about Ramaswamy’s Global Learning
Program at www.sph.unc.edu/glp.
• Read more about the School’s Certificate in Global
Health at www.sph.unc.edu/phlp/globalhealth.
Applications for fall 2010 will be accepted until
June 1.
• Read more about the online executive doctoral
program in health leadership on the School’s Web
site (www.sph.unc.edu/drph) and in the Spring
2006 issue of Carolina Public Health magazine
(www.sph.unc.edu/cph/drph).
(Left) Alumni Julie Golding and Ju-Yeon
Park multi-tasked between classes last
spring in the atrium.
Dr. James Porto Dr. William Zelman
0
1
2
3
4
5
6
7
8
9
Blogging or
on Twitter
0.6
8.5
0.6
2.3
In a virtual
community
Text
messaging
Instant
messaging
On social
networking
sites
E-mails
3.9
3.4
Working millennials in the U.S. report
how many hours per week they spend
using various technologies
This graph is based on statistics reported
in 2010 by Accenture, a global consulting
and technology firm. The full report is at
http://snipurl.com/accenture-millennials.
20 | SPRING 2 0 1 0
Orange
Zambezi
Volta
Niger
Benue
Lake
Tanganyika
AFRICA
REP. OF
THE
CONGO
LIBERIA
ANGOLA
NAMIBIA
ZIMBABWE
D'IVOIRE
CÔTE
EQUATORIAL GUINEA
GHANA
MALAWI
BURUNDI
UGANDA
CAMEROON
GABON
REPUBLIC
CENTRAL AFRICAN
TANZANIA
ANGOLA
ZAMBIA
LESOTHO
BOTSWANA
SOUTH
TOGO
N A M I B D E S E R T
D E S E R T
K A L A H A R I
Congo
DEMOCRATIC
REPUBLIC
OF THE CONGO
C O N G O
B A S I N
Kinshasa
RWANDA
“As the late Senator Daniel Patrick Moyni-han
once said, ‘You can’t solve a problem
until you first learn how to measure it,’” says
Meshnick, who leads a highly collaborative
Gillings Innovation Laboratory project to
quantify cases of HIV and tropical disease in
the Democratic Republic of the Congo (DRC).
Infectious diseases are the leading cause of
death and disability in developing countries
such as DRC. Yet remarkably, international
health and development organizations don’t
have good figures on how many people suffer
from these diseases.
“There aren’t reliable estimates or maps
of where people are,” says Meshnick, an epi-demiology
professor at UNC Gillings School
of Global Public Health. “This is a burning
public health problem.”
And he’s about to help extinguish it, first
for the DRC and then for other countries
that undertake similar projects. In April
2010, Meshnick planned to share his team’s
results with the DRC’s Ministry of Health,
after which the team was to write formal
reports of their findings. Such information
will allow aid groups to make better decisions
about where to expend money and resources.
Meshnick’s interdisciplinary team has
spent more than a year analyzing dried
blood-spot samples for prevalence of disease.
The team includes epidemiologists, geog-raphers,
molecular biologists and tropical
disease experts.
Under the guidance of three doctorate-level
Congolese researchers, two labs in
Kinshasa, DRC, are extracting serum from
samples to gauge levels of African sleeping
sickness. At UNC-Chapel Hill, the lab is
measuring HIV and malaria.
Researchers at UNC include epidemiol-ogy
postdoctoral fellow Steve Taylor, PhD,
microbiology doctoral candidate Martha
Clark, geography doctoral candidate Jane
Messina, assistant professor of microbiology
Julie Nelson, PhD, and associate professor of
geography Mike Emch, PhD.
The team records where people who have
the diseases are located. A high prevalence
of HIV was found in the war-torn eastern
areas, for instance. There also is a high
prevalence of malaria not only in rural areas,
as expected, but in densely populated areas
around Kinshasa.
Tracking
tropical disease
You may not hear an epidemiologist quote
a politician very often, but Steven R.
Meshnick, MD, PhD, has been known to.
Dr. Steven Meshnick (right) works
with Kashamuka Mwandagalirwa
(left) and Jeremie Muwonga to sort
dried blood-spot samples.
f e at u r e s a n d n ews
kathryn johnson
c a r o l i n a p u b l i c h e a l t h | 21
Tanganyika
Lake
Nyasa
Victoria
Lake
MALAWI
BURUNDI
UGANDA
ETHIOPIA
KENYA
TANZANIA
MOZAMBIQUE
Mt. Kilimanjaro
(highest point in
A ica, 5895 m)
G R E A T R I F T V A L RWANDA
But don’t think there’s funny business inside.
The unlikely laboratory is the place where
Mike Aitken, PhD, chair of UNC’s Depart-ment
of Environmental Sciences and Engi-neering,
is conducting research to stem water
and air pollution that comes from treated hog
waste, a big issue in North Carolina, the sec-ond
largest pork-producing state behind Iowa.
Through a Gillings Innovation Lab, Ait-ken
and his team purchased the trailer sec-ond-
hand. The ESE Design Center equipped
it to operate as an onsite laboratory. Now
parked by a hog-waste lagoon at Butler’s farm
near Lillington, the lab is testing Aitken’s
idea for removing ammonia, a noxious form
of nitrogen, from the waste.
Ammonia is a desirable fertilizer, but
too much of it damages soil and denigrates
groundwater. “There is more nitrogen pro-duced
from hog waste in eastern North
Carolina than could ever be used for crops
in that region,” Aitken says.
Furthermore, when farmers spray ammo-nia-
rich waste on crops as fertilizer—a common
practice­—
much of the ammonia is released to
the atmosphere, generating the smelly odor
If you visit Tom Butler’s hog farm in Harnett
County, N.C., you might spot a covered trailer
bearing the faint logo of a rodeo clown.
Converting hog waste
into energy
“We are currently looking into whether
HIV or drug-resistant malaria tends to asso-ciate
with refugee camps,” Meshnick says.
The team also looks at its data in light
of information from the Demographic and
Health Survey conducted in the DRC in
2007, which featured interviews with nearly
9,000 households. Surveyors also obtained
dried blood-spot tests to check for HIV, and
that’s where Meshnick’s team got its samples.
“We got the leftovers,” he says.
But the “leftovers” were enough for a
project that Meshnick believes will evolve
into something more extensive over the next
decade. Gene chips now being developed will
allow robots to analyze far more about DNA
than current methods can. These chips can
look at thousands of antibodies and patho-gens
from a dried blood spot.
“Ultimately, we could look for any disease
you can imagine,” Meshnick says. n
–Susan Shackelford
Dr. Steven Meshnick
Malaria Prevalence
DRC 2007
High: 94%
Low: 2% 8
Dr. Mike Aitken
janey messina/carol ina population center
f e at u r e s a n d n ews
22 | SPRING 2 0 1 0
for which hog waste is well known.
Ammonia also reacts in the atmosphere
to form fine particles that cause respiratory
problems such as asthma.
“This is a big public health problem,”
Aitken says, going on to describe the process.
“We are converting ammonia to nitrate, and
then nitrate to nitrogen gas, which represents
79 percent of our atmosphere and can be
harmlessly released.”
The process consists of conventional waste-water-
treatment technology, but two aspects
of the project are unusual, Aitken says.
It’s coupled with another project at the site
which captures methane from the treated hog
waste to generate electricity and thus mini-mize
the release of the potent greenhouse gas.
Under a pilot program the state began
in 2007, investor-owned utilities in North
Carolina are required to buy the electricity.
The farmer receives up to 18 cents per kilo-watt
hour, Aitken says. That far exceeds the
several cents per kilowatt hour that utilities
typically pay other power producers and thus
could significantly help offset the farmer’s
technology cost.
The other innovative part of Aitken’s
project is technical. At a nominal cost, InVen-tures
Technologies Inc. is providing a “bub-ble-
less” aeration system that supplies oxygen
required to convert the ammonia to nitrate.
This method is superior to traditional tank-and-
bubble systems for two reasons, Aitken
says. It minimizes the release of ammonia
from the treatment system and also may
minimize emission of the greenhouse gas
nitrous oxide, a by-product of the process.
Aitken began testing the ammonia-removal
system in the first quarter of 2009
and expects the demonstration to last a
year. Assisting him are graduate students
Sarah Bunk and Eric Staunton, as well as
Joe Rudek, PhD, a hog-waste policy expert
with the Environmental Defense Fund in
Raleigh, N.C., who holds master’s and doc-toral
degrees from the UNC department
Aitken heads.
While there are state incentives for the
energy-conversion process, both Aitken and
Rudek hope additional incentives, including
credits for carbon and nitrogen removal, will
emerge as legislation.
So far, Aitken says, “The state is not con-necting
the dots.”
He hopes to make the connections clear
soon. But for now, he says with a chuckle,
“The trailer is turned so that you can’t see
the clown logo from the road.” n
–Susan Shackelford
Field technician John McNeill (left) and Dr.
Glenn Walters, director of the ESE Design
Center, discuss design strategies for main-taining
pressure in a tank used to remove
nitrogen from hog waste. At right, plastic
covering over a hog waste lagoon not only
contains the noxious smell of ammonia but
also captures methane, which will be used
to generate electricity instead of being
released as a greenhouse gas.
Dr. Mike Aitken
l inda kastleman
tom fuldner
Dr. Mike Aitken
c a r o l i n a p u b l i c h e a l t h | 23
The naturally occurring compound is the
most harmful human carcinogen, says Miro-slav
Stýblo, PhD, associate professor of nutri-tion
at UNC Gillings School of Global Public
Health. It affects between 60 million and
100 million people around the world, most
of whom are exposed by drinking water that
has passed through geological formations
containing arsenic.
“We have good evidence that links chronic
arsenic exposure to cancers of the skin,
bladder, lungs and possibly the liver,” Stýblo
explains. “It can also cause a spectrum of
other diseases—cardiovascular disease, dia-betes
and probably many others.”
Stýblo’s Gillings Innovation Lab has taken
a two-pronged approach to the problem. One
objective is to develop techniques sensitive
enough to detect arsenic in very small tissue
samples.
The other goal is to analyze how arsenic is
metabolized in human tissues into compounds
more toxic than those found in drinking water.
The basic method for detecting arsenic in
human tissue was developed some time ago.
But researchers struggle with several chal-lenges,
primarily that the most toxic forms
of arsenic disintegrate when exposed to air.
Consequently, handling samples has been a
stumbling block. The problem is compounded
because areas where arsenic exposure is most
widespread—primarily Southeast Asia, Ban-gladesh
and the West Bengal region of India—
tend to be rural and less developed.
In 2009, Stýblo’s team designed a cus-tomized
lab at UNC that integrates and
modifies the work of two researchers in
Prague, Jiří Dědina and Tomáš Matoušek of
the Institute of Analytical Chemistry of the
Academy of Sciences of the Czech Republic.
Together, they have developed an inno-vative
and inexpensive
approach that uses very
small samples. While
fine-tuning the tech-nique,
they are sharing
it with three laboratories
in Mexico, another country where arsenic
causes widespread harm.
Now Stýblo’s lab is tackling its second chal-lenge,
analyzing the toxic compounds created
when the human body metabolizes arsenic.
Researchers previously have analyzed urine
samples to determine arsenic exposure, but
such samples can’t tell us what arsenic does
when it remains in human tissue.
Stýblo and his team are developing new
ways to discern arsenic’s impact on the lungs
and bladder. Andrew J. Ghio, MD, medical
officer in the U.S. Environmental Protection
Agency’s Human Studies Division, leads a
UNC-based study that provides Stýblo’s lab
with epithelial cells from the airways of smok-ers
exposed to arsenic in cigarette smoke. Two
researchers in Mexico, Luz María Del Razo of
the Research and Advanced Studies Center of
the National Polytechnic Institute of Mexico
(Cinvestav–IPN) and Gonzalo García Vargas
of Universidad Juarez del Estado de Durango,
supply exfoliated bladder cells isolated from
the urine of Mexican residents exposed to
arsenic in drinking water.
Stýblo’s innovative analytical methods
will give epidemiologists cheaper and better
ways to identify and understand how arsenic
harms human beings. The goal, he says, is to
transfer this methodology to the field. That
will give those working to stop a killer a new
weapon to use. n
–Kathleen Kearns
Unraveling the mystery
of arsenic’s modi operandi
Murder mysteries have given arsenic a sinister
reputation, but the damage it does is no fiction.
Stýblo is developing new ways to discern how arsenic
impacts the human lungs and bladder.
Dr. Stýblo (center) poses
with Dr. Luz María Del
Razo (second from left),
UNC’s Dr. Zuzana Drobna
(in orange), Mayor
Eusebio Aguilar and local
public health workers in
Zimapan, Mexico.
Dr. Miroslav Stýblo
dr gonzalo garcia-vargas
24 | SPRING 2 0 1 0
So where do you find a “safe” job for teen-age
workers? A clothing store at the mall?
A fast-food restaurant? About 77 percent of
teens who work have jobs in retail and service
industries, according
to the Bureau of Labor
Statistics. Those jobs
might seem safer than
jobs in construction
or agriculture.
But Carol Runyan,
PhD, director of the
UNC Injury Preven-tion
Research Center
and professor of health behavior and health
education at the UNC Gillings School of
Global Public Health, wants young workers
and their families to know that injuries occur
on all kinds of job sites. More than 200,000
teenagers are injured on the job each year.
“Food slicers, hot grease, slippery floors
and box crushers account for some of these
injuries,” Runyan says. “Restaurants, food
stores and the fast-food industry can be haz-ardous
places for young workers.”
Fifteen years ago, Runyan and her team
collected statistics on young worker fatali-ties
in North Carolina. She wanted to help
prevent these deaths, so she began analyzing
the circumstances in which teens work.
The national study she led, interviewing
about 900 youth workers in retail and service
occupations, showed that one-third of the
respondents did not receive safety training
and many worked without supervision. Her
survey of teenagers working in construction in
N.C. found that 84 percent of those surveyed
performed tasks prohibited by child labor laws.
“My research leads to where interventions
need to be,” Runyan says.
She identified interventions including
enforcement of and education about child
labor laws and development of strategies
to ensure worker safety, such as employers’
learning how best to supervise teenagers.
“Young workers lack experience,” says
Runyan. “In an attempt to demonstrate com-petence,
they may take risks, not understand-ing
the hazards involved. The responsibility
for safety lies with the employer—and with
the government, to set regulations, monitor
compliance and then hold employers’ feet
to the fire.”
Runyan’s work has been groundbreaking
in its impact on young workers’ safety. In
2009, after significant media coverage of
her studies, she was urged by N.C. Rep. Jen-nifer
Weiss and the N.C. Child Fatality Task
Force to share her results with several legis-lative
committees, leading to two new laws
designed to protect working children. One,
a law with tougher penalties for employer
violations, went into effect in North Caro-lina
in December 2009. The other requires
the N.C. labor commissioner to provide
detailed reports on child labor complaints
and obstacles to child labor law enforcement.
“This is an important step in raising
awareness of young worker safety and the
need to ensure that employers are account-able,”
Runyan says. n
–Chris Perry
Safety first on the job,
especially for inexperienced teens
Wanted: Secure job for teenage worker.
Prefer no big equipment, no tractors or
trucks, no heavy lifting. Safety is a top priority.
Agriculture/forestry/ Construction
fishing/hunting
Transportation/warehousing
Manufacturing
Retail trade
N=6,290
Information
Education/health
services
Other
Leisure/hospitality
Data provided by Janice Windau of the U.S. Bureau of Labor Statistics, from the Bureau's Survey of Occupational Injuries
and Illnesses. Reprinted with permission from the Web site of the U.S. Centers for Disease Control and Prevention's
National Institute for Occupational Safety and Health (http://snipurl.com/cdc-young-worker-injury).
The majority of young
people injured on the job
work in the service and retail
industries. (Shown here are
U.S. data for 2007.)
Dr. Carol Runyan
“Restaurants, food stores and the fast-food
industry can be hazardous places for
young workers,” says Dr. Carol Runyan.
l inda kastleman
f e at u r e s a n d n ews
But a decade of work by North Carolina
public health and dental researchers at UNC
has resulted in a kind of magic of its own­—
innovative programs that really do brighten
the smiles of the state’s youngest and most
vulnerable.
One of the prevention programs is work-ing
so well that 35 other states have adopted
North Carolina’s model.
Into the Mouths of Babes was established
in 2000 by a collaborative of public and
private medical and dental groups, with
funding from N.C. Medicaid. The initiative
trained physicians to paint fluoride varnish
on infants’ and young children’s teeth, screen
for tooth decay and provide dietary and other
dental health information to their parents.
The program already reaches Medicaid-covered
children in North Carolina in 45
percent of their well-child visits, says Gary
Rozier, DDS, MPH, professor of health policy
and management at the UNC Gillings School
of Global Public Health.
Rozier and others founded the program
after seeing an increase in dental disease
in young children, particularly those from
low-income families and those with poor
access to dental care. The program marked
the first time physicians started “‘working
in the mouth,’ if you will,” said Rozier, who
holds a Doctor of Dental Surgery from UNC-Chapel
Hill.
In conjunction with Into the Mouths of
Babes, Rozier helped develop two more proj-ects
to serve the dental
needs of young North
Carolinians.
Carolina Dental
Home is a pilot program
in Craven, Jones and
Pamlico counties that
works to ensure access to pediatric dental
services despite a shortage of dentists. Using
an assessment tool developed by UNC and the
N.C. Division of Public Health’s Oral Health
Section, physicians evaluate a child’s teeth and
risk factors and decide whether to continue
treating the child or refer him or her to a gen-eral
or pediatric dentist trained through the
program to work with young children. Physi-cians,
for instance, will advise parents about
health behaviors, such as the use of fluoridated
toothpaste, but will refer a child with a cavity
to a participating dentist. Officials have seen
increased referral rates and improved efficiency
since the program started, Rozier said.
“All of these efforts are focused on increas-ing
access to preventive services at an early age
so we can get to these kids before disease occurs
and prevent poor outcomes like hospitalization,
which is much too frequent,” Rozier said.
“The many collaborations between Dr.
Rozier and the Oral Health Section of the
N.C. Division of Public Health are a model
for the state,” said Rebecca King, DDS, MPH,
chief of the Oral Health Section. “Working
together, the public health school and the state
health department bring together the best of
the worlds of research and public health prac-tice—
to the benefit of North Carolinians.”
The other new project aims to promote
preventive dental care in Early Head Start
programs. Children who attend a participat-ing
Early Head Start program have their teeth
brushed with fluoridated toothpaste at least
once every day in the classroom. Teachers
learn about oral health care and relay the
information to parents and caregivers. Seven-teen
programs participate in the Early Head
Start initiative in North Carolina, Rozier said.
Combined, the three programs provide a
long list of benefits for preschool-aged children
and their families. They help prevent tooth
decay, reduce the amount of treatment a child
needs and generally improve the oral-health-related
quality of life for families, Rozier said. n
–Natalie Gott
All of these efforts are focused on increasing
access to preventive services at an early age.
Dr. Gary Rozier (center)
discusses his work in
North Carolina with
(l-r) project manager
Leslie Zeldin; Dr. William
Vann Jr., professor of
dentistry; postdoctoral
fellow Dr. Bhavna Pahel;
and Dr. Daniel Lee.
Putting new ideas where
their mouths are
Face it­—
no tooth fairy is going to swoop in and
mend the mouths of children with poor oral health.
c a r o l i n a p u b l i c h e a l t h | 25
l inda kastleman
26 | SPRING 2 0 1 0
Both local and national media
have sought out School faculty members to
comment on aspects of the national debate
on health care reform, particularly after a
bill was passed in March. Among those most
often quoted are Tim Carey, MD, director
of the Cecil G. Sheps Center for Health Ser-vices
Research and adjunct epidemiology
faculty member; Dean Harris, JD, clinical
associate professor of health policy and
management; Jon Oberlander, PhD, profes-sor
of health policy and management and
social medicine; and Thomas Ricketts, PhD,
professor of health policy and management.
Media included The New England Journal
of Medicine, The New York Times, National
Public Radio, USA Today, MSNBC, CBS Sun-day
Morning and Evening News programs,
American Public Radio’s Marketplace, AARP
Bulletin Today, The Daily Tar Heel (UNC),
WCHL Radio and The News & Observer
(Raleigh, N.C.).
Health policy and management doctoral
student Brad Wright also blogs about health
care reform in The Huffington Post (see www.
huffingtonpost.com/d-brad-wright). n
In fiscal year 2009, despite a major
economic recession, more than 400 grants
and contracts, totaling more than $150 mil-lion,
were awarded to faculty members with
a primary appointment in the School—a 45
percent increase from the previous year.
Among the highlights:
Gates Foundation grant for
urban reproductive health
The Bill & Melinda Gates Founda-tion
awarded more than $22 million for a new
project to improve reproductive health of the
urban poor in sub-Saharan Africa and South
Asia. Ilene Speizer, PhD, research associate
professor of maternal and child health, is one
of the two leaders of “Measurement, Learn-ing
and Evaluation for the Urban Reproduc-tive
Health Initiative,” which will be run by
UNC's Carolina Population Center. Working
with the center on the project are the African
Population and Health Research Center, based
in Nairobi, Kenya, and the Population Refer-ence
Bureau in Washington, D.C. The project
will help identify which urban reproductive
health approaches and interventions are most
effective and likely to have the biggest impact.
Statistical Methods for
Cancer Clinical Trials
Michael R. Kosorok, PhD, professor
and chair of the biostatistics department, will
lead researchers from UNC, Duke University
and N. C. State University to find ways to
design more powerful clinical trials for cancer
treatments. Their aim is to more quickly and
effectively deliver better, more personalized
new therapies to cancer patients. “Statistical
Methods for Cancer Clinical Trials,” a $12.5
million, 5-year grant from the National Cancer
Institute, is designed to develop new methods
for the design and analysis of cancer clini-cal
trials. Co-investigators from the School
include Joseph Ibrahim, PhD, Alumni Dis-tinguished
Professor of biostatistics; Jianwen
Cai, PhD, biostatistics professor and associate
chair; and Danyu Lin, PhD, Dennis Gillings
Distinguished Professor of biostatistics.
Center of Excellence
in Genomic Science
The National Institutes of Health’s
National Human Genome Research Institute
and National Institute of Mental Health have
awarded UNC an $8.6
million, 5-year grant
to establish a Cen-ter
of Excellence in
Genomic Science. The
center will explore
how genes and the
environment inter-act
and affect certain
mental diagnoses,
including autism, depression, anxiety and
adverse reaction to antipsychotic medicines.
Public health researchers include Daniel
Pomp, PhD, nutrition professor; and Fred
Wright, PhD, professor, Fei Zou, PhD, asso-ciate
professor, and Wei Sun, PhD, assistant
professor, all in biostatistics.
Sobsey presents water test idea to
NASA, USAID and others
Mark Sobsey, PhD, Kenan Distin-guished
Professor of environmental sciences
and engineering, is one of 10 innovators
who participated in the first LAUNCH
SCHOOL NEWS
For more information on these topics and other news, please see www.sph.unc.edu/news_events.
unc gil l ings school of globa l publ ic hea lth
Explaining the health
care reform debate
Major grants
Dr. Daniel Pomp
Dr. Jon Oberlander Dr. Thomas Ricketts
c a r o l i n a p u b l i c h e a l t h | 27
Social media sites provide an easy, and
now mainstream, means to share informa-tion
about research, practice and education
opportunities—and a great way to network
with colleagues, classmates and others.
UNC Gillings School of Global Public
Health offers a variety of ways for students,
alumni and friends to stay connected with
the School and each other around the world.
Check out these opportunities:
Tap into relationships and stay informed.
www.linkedin.com
Post or search for jobs in public health.
www.uncsph.experience.com
Find alumni in our online community.
www.alumniconnections.com/sph.unc.edu
Follow the School on Twitter.
www.twitter.com/uncpublichealth
Check out the School’s YouTube channel.
www.youtube.com/user/UNCpublichealth
Picture what the School has been up to.
www.flickr.com/photos/uncsph/collections
Join our Facebook community.
www.facebook.com
For links to more
School connections
(Dean’s blog, events
calendar, RSS feeds,
iTunes podcasts,
myspace, Second Life,
Wikipedia, Student
Affairs blog), visit
www.sph.unc.edu/
more_connections.
event, held March 16–18, 2010, at Kennedy
Space Center in Florida. LAUNCH spon-sors
include NASA, the U.S. Agency for
International Devel-opment
and the U.S.
State Department.
The inaugural event
focused on water sup-ply
and quality.
Sobsey presented a
proposal for simple,
accessible, afford-able
tests to assess
water quality and safety to the 30-member
LAUNCH Council, a diverse group of entre-preneurs,
scientists, engineers and others
who advised presenters about how to move
their innovations forward into commercial
production, field deployment and use.
Sobsey received a Gillings Innovation
Laboratory to develop portable field tests to
detect fecal contamination in water. He and
an international team are designing reli-able
fecal microbe tests that will not require
sophisticated laboratory equipment, electric-ity
or advanced training of test users. n
Technology enhances communication
about the School
Dr. Mark Sobsey
Events and other news
Minority Health Conference
addresses health inequality
in the modern world
The 31st annual Minority Health Con-ference,
“Building Community in the Age of
Information: Fighting Health Inequality in
the Modern World,” was held Feb. 26, 2010,
at the William and Ida Friday Center for
Continuing Education in Chapel Hill, N.C.
The event was planned and hosted by the
School’s Minority Student Caucus.
Columbia University’s Robert E. Fullilove,
EdD, presented the 12th annual William T.
Small Jr. Keynote Lecture. The conference is
the largest and longest-running student-led
health conference in the country, regularly
attracting more than 500 students, faculty,
researchers, public health and human services
professionals, and community leaders from
N.C. and surrounding states, with at least as
many throughout the country viewing the
keynote lecture by webcast or on DVD.
Online learning certificates
now offered
The School now offers two new online
learning programs for students not seek-ing
degrees. The Public Health Leadership
Program’s online certificate in global health
confers academic certification in global
health competencies, focusing on global
health issues, ethics, epidemiology and
Dr. Robert Fullilove (above) presented the
keynote lecture at the 2010 UNC Minority
Health Conference. Health behavior and
health education students Aprajita Anand
(left) and Emily Brostek led a team of stu-dents
in planning and executing the event. 8
photos by l inda kastleman
28 | SPRING 2 0 1 0
s c h o o l n ews
monitoring evaluation. Apply by June 1,
2010. Learn more at www.sph.unc.edu/phlp/
globalhealth.
The Certificate in Maternal and Child
Health Leadership (MCH Olé!) provides prac-titioners
with core knowledge and skills to
promote the health of women, children and
families around the world. Apply by Oct.
1, 2010. Learn more at www.sph.unc.edu/
mch_online.
New dissertation
awards and merit-based
scholarships offered
Two new programs to support students
have been funded through Carolina Public
Health Solutions, the group administering
the $50 million gift to the School from Den-nis
and Joan Gillings.
As many as two dissertation awards will
be granted to current doctoral candidates
whose work has strong potential for public
health impact. The $5,000 award(s) will be
presented in spring 2010.
Any student applying to a UNC graduate
degree program in public health also will be
eligible to receive merit-based scholarship
support. The School plans to make funding
pools available each year. Academic depart-ments
and the Public Health Leadership
Program will consider applications and make
funding decisions.
Guest lecturers enrich
School experience
Numerous distinguished guests
have made presentations at the School
over the past several months. Below are
Dr. Thomas Frieden
Career fair provides networking opportunities
More than 275 students, alumni
and others attended the School’s
2010 Career and Internship Fair
on Feb. 4, 2010. Thirty-three
companies and agencies sent
representatives to meet some
of the best trained public health
students in the world.
This year, Abt Associates was a
“Gold Sponsor” of the event. Abt
associates apply their expertise
in research, consulting, technical
assistance, data collection, and
medical and life sciences to a
wide variety of problems in the public and private sec-tors.
(See www.abtassociates.com.)
The School thanks Abt and other career fair
sponsors, including ICF International, RTI International
and the School Alumni Association. Read more about
the event at www.sph.unc.edu/career_fair. n
highlights of a few who have shared their
experiences and expertise. To hear many of
these lectures online, visit www.sph.unc.
edu/webcasts.
Dean’s Lecture Series
CDC Director Thomas Frieden, MD,
MPH, spoke on Oct. 9, 2009, about the
ways public health training “bridges the
implementation gap.” More than 400 people
packed the School’s atrium to hear Frieden
discuss Centers for Disease Control and
Prevention and public health priorities,
including improvement of public health sur-veillance
and epidemiology, support of state
and local public health action, strengthening
of global health work and having greater
impact on public health policies.
Dan Ariely, PhD, James B. Duke
Professor of Behavioral Economics at
Duke University and author of Predictably
Irrational: The Hidden Forces That
Shape Our Decisions, presented a talk,
“Predictably Irrational,” on March 26, 2010.
James Marks, MD, MPH, senior vice
president of the Robert Wood Johnson
Foundation, spoke to faculty, staff and
students on April 9, 2010. His talk was
titled “Wayne Gretzky and the Future of
Public Health Leadership.”
2010 Foard Lecture
Jeanne Lambrew,
PhD, director of the
U.S. Department of
Health and Human
Services’ Office of
Health Reform, was
expected at press
time to deliver the
2010 Fred T. Foard Jr.
Memorial Lecture on
April 15 at The Wil-liam
and Ida Friday Center for Continuing
Education in Chapel Hill, N.C. Lambrew
received master’s and doctoral degrees in
health policy (in 1991 and 1993, respec-tively)
from UNC. n
Dr. Jeanne Lambrew
l inda kastleman
Company representative
Brad Hollern and master’s
candidate Alrick Edwards
talk to students about
job opportunities at Abt
Associates.
c a r o l i n a p u b l i c h e a l t h | 29
Harriet Hylton Barr
(1925–2009)
Harriet Hylton Barr, MPH, alumna
and longtime health educator at the School,
died Dec. 14, 2009, in
Durham, N.C. Barr
received a Master of Pub-lic
Health in health edu-cation
from UNC in 1948
and taught health educa-tion
classes at UNC from
1967 to 1994. She served
as the School’s assistant
dean for alumni affairs from 1983 to 1994,
during which time she organized and energized
an alumni association. In 1980, the association
recognized Barr with its Distinguished Service
Award, later renamed in her honor. The Harriet
Hylton Barr Distinguished Alumnus Award
is presented annually to recognize leader-ship,
collaboration and innovation within the
profession of public health; impact within the
practice arena; and outstanding service.
A special remembrance was part of the
School's Foard Memorial Lecture on April
15, 2010.
Memorial donations may be made to the
UNC Gillings School of Global Public Health
Foundation—Harriet Barr Memorial Fund.* n
Barry Margolin
(1943–2009)
Barry Margolin, PhD, former chair of the
School's Department of Biostatistics, died Jan.
28, 2009, after many years
of declining health. Margo-lin
joined the biostatistics
faculty in 1987 as profes-sor
and chair, a position
he held until 1999. He also
served as director of the
biostatistics facility at the
UNC Lineberger Com-prehensive
Cancer Center from 1989 to 1999.
A remembrance ceremony was held at the
School on March 3, 2010. A memorial session
honoring Margolin's distinguished career will
be held at the Joint Statistical Meetings in Van-couver,
Canada, on Aug. 3, 2010. n
Jessie Satia (1971–2010)
Jessie Satia, PhD, associate professor of nutrition
and epidemiology and special assistant to the School's
dean for diversity, died in her home in Chapel Hill, N.C.,
on Feb. 4, 2010, after a long illness.
During her career, Satia published more than 65
papers and authored two book chapters. Her numerous
awards and honors include the Graduate Student Fel-lowship
Award from the University of Washington and
the New Investigator Award from the American Society
of Preventive Oncology in 1999. In 2001, she won the
Dannon Leadership Institute's Nutrition Leadership
Institute Award. She was a three-time recipient, in 1999,
2001 and 2003, of the Minority Research Scholar Award
given by the American Association for Cancer Research.
Satia explored methods and strategies to recruit African-Americans into research studies
for cancer prevention and control. She also assessed and monitored trends in health-related
behaviors among colon and prostate cancer survivors and examined whether health behav-iors
impact cancer prognosis and survival.
Memorial donations may be made to The Dr. Jessie A. Satia Memorial Fund.* n
Mary Rose Tully (1946–2010)
Mary Rose Weber Tully, MPH, alumna and
adjunct associate professor of maternal and child health,
died Jan. 20, 2010, at the N.C. Cancer Hospital in Chapel
Hill, N.C.
Tully was a co-founder and senior clinical associate
of the Carolina Global Breastfeeding Institute in the
Department of Maternal and Child Health. She also
was director of Lactation Services at UNC Hospitals
and a faculty member in the UNC schools of medicine
and nursing.
Memorial donations may be made to The Mary Rose
Tully Training Initiative at the Carolina Global Breast-feeding
Institute.* n
M e m Ionriam
* To make a memorial gift, please visit www.sph.unc.edu/giving, or contact Kembrie Greene Farrow,
Office of External Affairs, UNC Gillings School of Global Public Health, 107 Rosenau Hall, Campus
Box 7400, Chapel Hill, N.C. 27599-7400, telephone (919) 966-0198.
30 | SPRING 2 0 1 0
FACULTY
Devlin joins School as Gillings Visiting
Professor
Leah M. Devlin, DDS,
MPH, former N.C.
State Health Direc-tor,
was appointed
as a Gillings Visiting
Professor in fall 2009.
The position is based
in the Department
of Health Policy and
Management.
In her new role, Devlin is connecting the
School, including the N.C. Institute for Public
Health, with legislators and others working
on public health issues in practice. She also
is consulting with School leaders to develop
approaches to strengthen the school’s capac-ity
as a regional and national leader in public
health quality improvement.
Steckler and Eng recognized as Distin-guished
Fellows, SOPHE’s highest honor
Allan B. Steckler, DrPH, and Eugenia (Geni)
Eng, DrPH, professors of health behavior
and health education, received the Society
for Public Health Education’s Distinguished
Fellow Award for significant and lasting
contributions to SOPHE and to the profes-sion
of health education.
The awards, which are the Society’s high-est
honor, were presented at the organiza-tion’s
annual meeting in Philadelphia in
November 2009.
SOPHE is an independent, international
professional association made up of health
education professionals and students.
Herring elected president of ENAR,
prestigious biostatistics organization
Amy Herring, ScD,
associate professor
of biostatistics, was
elected president of the
Eastern North Ameri-can
Region (ENAR) of
the International Bio-metric
Society (IBS)
for a three-year term,
ending in 2013.
IBS is the largest professional organization
of biostatisticians and biometricians in the
world, drawing its 5,800 members from more
than 25 countries. ENAR is the largest sub-group
of the organization, incorporating 1,600
members from the United States and Canada.
Our School has a strong history of leader-ship
in the society, with four members of
the faculty—including the late Dr. Bernard
Greenberg and Drs. Jim Grizzle, Gary Koch
and Lisa LaVange—having previously served
as president.
Richardson
appointed to White
House advisory board
David B. Richardson,
PhD, associate profes-sor
of epidemiology,
was appointed by
President Obama in
October 2009 to the White House Advisory
Board on Radiation and Worker Health.
Richardson’s research investigates occupa-tional
and environmental causes of disease,
with a particular focus on ionizing radiation.
He has served in various capacities at the
University of North Carolina since 1996 when
he began as a postdoctoral researcher.
Dilworth-Anderson
leads Gerontological
Society, receives
Reagan Award for
Alzheimer’s research
Peggye Dilworth-
Anderson, PhD, pro-fessor
of health policy
and management and
interim co-director of
UNC’s Institute on Aging, was inducted in
November 2009 as the new president of the
awards &
R ecognitionS
unc gil l ings school of globa l publ ic hea lth
August 2009 – March 2010
Details of these and other awards are available at www.sph.unc.edu/school/recognitions.
Dr. Leah Devlin
Dr. Eugenia Eng and Dr. Allan Steckler
Dr. Amy Herring
Dr. David Richardson
Dr. Peggye Dilworth-
Anderson
c a r o l i n a p u b l i c h e a l t h | 31
Gerontological Society of America at GSA’s
62nd annual meeting in Atlanta, Ga.
Dilworth-Anderson is a member of the
National Advisory Council for the National
Institute on Aging and former member
of the board of directors of the National
Alzheimer’s Association.
Dilworth-Anderson also received the
Ronald and Nancy Reagan Research Insti-tute
on Alzheimer’s Disease Award. She
was honored on March 9, 2010, during the
seventh annual National Alzheimer’s Gala in
Washington, D.C.
Baric elected to
American Academy
for Microbiology
Ralph Baric, PhD,
professor of epidemiol-ogy
at UNC Gillings
School of Global Pub-lic
Health, has been
elected to the Ameri-can
Academy for Microbiology. He will be
recognized at the Academy Fellows luncheon
in San Diego in May 2010.
The American Academy of Microbiol-ogy
is the honorific leadership group within
the American Society for Microbiology, the
world’s oldest and largest life science orga-nization.
Baric’s groundbreaking research
focuses on coronaviruses, including SARS,
and on noroviruses.
Read more about his research on page 10.
Adimora selected as one of top 100 African-
American leaders by The Root magazine
Adaora Adimora, MD, MPH, professor of
medicine at the UNC
School of Medicine
and clinical professor
of epidemiology in the
public health school,
was selected by The
Root magazine as one
of the top 100 African-
American leaders.
The Root is a
daily online magazine that aims to provide
thought-provoking news commentary from a
variety of black perspectives. “The Root 100”
is a new honor that highlights the leadership
and service of African-American men and
women whose work impacts their communi-ties
and the world.
Adimora was honored for her research in
HIV/AIDS.
Pink awarded distinguished professorship
in health policy and management
George Pink, PhD,
has been appointed
Humana Distin-guished
Professor of
Health Policy and
Management.
Established
through a grant from
the Humana Founda-tion,
the professorship
is awarded to a health policy and manage-ment
faculty member with a national reputa-tion
for scholarship in health informatics.
Pink is a fellow at the UNC Cecil G. Sheps
Center for Health Services Research and lead
investigator in the center’s N.C. rural health
research and policy analysis center.
Ammerman appointed to state food
advisory council
Alice Ammerman,
DrPH, professor of
nutrition and director
of UNC’s Center for
Health Promotion and
Disease Prevention,
has joined a new state
council focused on
improving policies and
access to local, sustain-able
food in North Carolina.
The North Carolina Sustainable Local
Food Advisory Council was established
by the N.C. General Assembly in August
2009 to study, develop and promote policies
that will create jobs, support communities,
preserve the natural environment, increase
access to fresh and nutritious foods, and
provide greater food security for all North
Carolinians.
Holliday wins award from N.C. Dietetic
Association for contributions to field
Amanda Holliday,
MS, RD, clinical
assistant professor in
the Department of
Nutrition, was named
Outstanding Dietetic
Educator of the Year
by the Durham-Chapel
Hill (N.C.) Dietetic
Association and by
the North Carolina Dietetic Association. She
accepted the statewide award at an awards
event in Princeton, N.J., on March 25, 2010.
STUDENTS
Graduate School announces 24 merit
awards for public health students
Twenty-four UNC public health graduate
students received merit awards for study in
2009–2010 and beyond, the UNC Graduate
School announced in fall 2009.
The students are Sayan Dasgupta (biosta-tistics);
Jonathan Crocker, Katherine Harrold
and Edema Ojomo (environmental sciences
and engineering); Jane Der, Katelyn Haus-man,
Chantel Martin, Melanie Napier, Damon
Ogburn and Amitabh Suthar (epidemiology);
Andrea Des Marais, Ann Gottert, Jessica
Kadis, Elizabeth King and Sarah Lieff (health
behavior and health education); Kristin
Geonnotti, Elise Lockamy and Sarah Rutstein
(health policy and management); Anna Bauer
and Anupama Gomez (maternal and child
health); and Scott Ickes, Erik Karlsson, Tosha
Smith and Rebecca Tkachuk (nutrition).
Health policy and management teams
compete in case competitions
Presha Patel, Gregory Mascavage and Jessica
Folmar, second-year Master of Public Health
students in the health policy and manage-ment
department, won second place in the
14th annual Everett V. Fox Student Case
Dr. Ralph Baric
Dr. Adaora Adimora
Dr. George Pink
Dr. Alice Ammerman
Amanda Holliday
8
f e at u r e s a n d n ews
32 | SPRING 2 0 1 0
Competition, held during the National
Association of Health Services Executives’
annual educational conference in October
2009, in Orlando, Fla.
The competition offers first- and second-year
graduate students an educational experi-ence
to enhance their problem analysis and
presentation skills. Students are charged
with applying their creativity, knowledge and
experience to analyze real and diverse issues
facing a health care organization.
Ashley Winslow, Sadaf Houssain and
Matt Hasbrouck, graduate students in health
policy and management, were among the top
five teams at the University of Alabama at
Birmingham’s annual health care case com-petition
on Feb. 11, 2010. A total of 24 teams
participated in the competition.
Doctoral candidate Long among those
honored with UNC teaching awards
Dustin Long, doctoral candidate in bio-statistics,
has received a Tanner Award for
Excellence in Undergraduate Teaching by
a Graduate Assistant. The award, given
annually to five UNC
graduate assistants,
carries a $5,000
stipend.
Long was among
21 students and
faculty members who
received teaching
awards in January.
Phi Beta Kappa inducts
nine undergraduates from
UNC public health school
Nine of the 146 UNC under-graduates
inducted into
Phi Beta Kappa in fall 2009
hail from four public health
departments.
The students, all from
North Carolina, include
Kateland Elizabeth Branch,
Julia Vivian Loewenthal and
Patty Tian Wang (nutrition);
Bita Jasmine Emrani, Jared
Richard Lowe and Pranay Prabhakar (health
policy and management); Patrick Nathaniel
Healy and Andrew Parker Morgan (bio-statistics
and biology); and Rachel Parker
Stevens (environmental health science).
King, PHLP master’s student, wins Kuno
Research Award
Bradley King, a Master of Public Health stu-dent,
has received the Michiko Kuno Award
for Excellence in Student Research. The
award, presented Jan. 27 as part of the UNC
School of Medicine’s John B. Graham Medi-cal
Student Research Day, recognized King’s
research on diabetic retinopathy screening.
King is a health care and prevention
student in the public health school’s Public
Health Leadership Program and has com-pleted
his third year of medical school at UNC.
STAFF
NCIPH’s Place receives leadership award
Janet Place, direc-tor
of the Southeast
Public Health Train-ing
Center, part of
the N.C. Institute for
Public Health, has
received an award for
Best Leadership Proj-ect
at the Southeast
Public Health Lead-ership
Institute (SEPHLI) meeting, held in
Winston-Salem, N.C. Her project was titled
“Workforce Development Roadmap.”
ALUMNI
Alumnus Jenkins presented with APHA’s
Lilienfield Award for teaching excellence
Bill Jenkins, PhD,
MPH, received the
American Public
Health Associa-tion’s
2009 Abraham
Lilienfield Award,
which recognizes
excellence in the
teaching of epide-miology
during the
course of a career. An alumnus of the UNC
Gillings School of Global Public Health,
Jenkins is an affiliate of the UNC Institute
of African-American Research (www.unc.
edu/iaar) and co-director of UNC’s Minor-ity
Health Project. He previously had a
long, successful career at the U.S. Centers
for Disease Control and Prevention and at
the Center for Research on Health Dispari-ties
at Morehouse College in Atlanta.
N.C. INSTITUTE FOR
PUBLIC HEALTH
NCIPH honored for state service
The North Carolina Institute for Public
Health (NCIPH) received the N.C. Public
Health Association’s Partners in Public
Health Distinguished Group Award in
October 2009 at the Association’s 100th
anniversary meeting in Asheville.
The Institute, directed by Ed Baker, MD,
MPH, research professor in the Depart-ment
of Health Policy and Management,
celebrated its tenth anniversary in 2009,
highlighted by an event on Friday, Oct. 9.
The NCPHA award was established in
1998 to recognize organizations and profes-sions
that have made significant contribu-tions
to public health in North Carolina. n
awa r d s a n d r e co g n i t i o n s
Janet Place
Dr. Bill Jenkins
Dustin Long
(L-R) Presha Patel, Gregory Mascavage, Jessica Folmar
Details of these and other
awards are available at
www.sph.unc.edu/school/
recognitions.
c a r o l i n a p u b l i c h e a l t h | 33
Donor s
O U R D ON OR S
Supported by a $1.5 mil-lion
gift from Glaxo-
SmithKline, two of the School’s
researchers are teaming up
with N.C. Gov. Bev Perdue and
others to “eradicate cervical
cancer” in North Carolina—
the first step toward ending the
disease nationwide.
The Cervical Cancer-Free
Initiative, led by Noel Brewer,
PhD, assistant professor of
health behavior and health
education, and Jennifer S.
Smith, PhD, research associ-ate
professor of epidemiology,
will develop a plan for the state
based on evidence that cervi-cal
cancer can be prevented
through vaccines and effective
screening. Former North Caro-lina
State Health Director Leah
Devlin, DDS, who is a Gillings
Visiting Professor at the school,
is an adviser to the project.
At the outset, the initiative
aims to bring a coalition of
stakeholders together to iden-tify
opportunities for and bar-riers
to prevention, screening
and treatment. The research-ers
also will develop a project
to increase in-school
access to vaccines,
including the HPV
vaccine which pre-vents
infection with
the virus that causes
most cervical cancer.
The initiative also
will coordinate efforts
in California (via the
California Medical Associa-tion
Foundation), Alabama
and, eventually, other states.
Each state will build a coalition
of key stakeholders in cervical
cancer prevention, including
government, private, nonprofit
and community groups.
"North Carolina is a tre-mendous
leader in this multi-state
effort to end cervical
cancer," said Governor Perdue.
"Initiatives like this go hand-in-
hand with efforts such as
our state's investment in the
University Cancer Research
Fund, a historic commitment
to preventing and treating
cancer through innovative
medical research within our
world-class universities." n
–Natalie Gott
New cervical cancer initiative aims to save lives
Jack Allison, a 1966 UNC alumnus,
has composed "Dedication Song" to
honor the UNC public health school’s new
name as of September 2008—UNC Gillings
School of Global Public Health.
The song celebrates new possibilities
for growth at the School, thanks to Den-nis
and Joan Gillings' generous donation.
Allison began writing songs while
serving in the Peace Corps from 1967
to 1969, when he worked in a children’s
clinic in Nsiyaludzu, Nigeria. He had an
urge to see the world "outside the class-room"
after graduating from UNC with
a chemistry degree.
His songs contained lyrics with simple
lessons for new mothers, which, if fol-lowed,
would improve their babies' health.
Since his first efforts, Allison has
raised more than $150,000 in charity
through his music, establishing the Self
Help Foundation to manage funds gener-ated
by his songs.
When he heard about the School’s
name change, he took the initiative to
compose "Dedication Song" to commemo-rate
the occasion. Allison based the lyrics
on key words used to promote the School’s
goals, namely, anticipation, acceleration
and innovation.
A copy of the CD is avail-able
upon request to anyone who
makes a gift of $25 or more to the
School’s global health program.
For more information, contact
the School's Office of External
Affairs at (919) 966-0198. n
–Jay Cartwright
Allison composes song to celebrate School
Jack Allison and his wife, Sue
Wilson, are shown here with
friends in Nsiyaludzu, Malawi.
Dr. Noel Brewer Dr. Jennifer Smith
North Carolina is a tremendous leader in
this multi-state effort to end cervical cancer,
34 | SPRING 2 0 1 0
DONORS
Doctoral student Virginia
Senkomago, MPH, of
Uganda, received a Tellus Edu-cational
Foundation scholar-ship
to study infectious disease
epidemiology, particularly
sexually transmitted diseases
in sub-Saharan Africa.
Senkomago, who also
received The Winstanly Schol-arship,
funded by Derek and
Louise Winstanly, currently is
a research assistant on a proj-ect
led by Frieda Behets, PhD,
associate professor of epidemiol-ogy
at UNC Gillings School of
Global Public Health. Behets’
project focuses on sustainable
delivery of antiretroviral med-icine
to HIV patients in the
Democratic Republic of Congo
(DRC).
Senkomago is particularly
interested in HIV/AIDS in sub-
Saharan Africa because of the
toll it takes on individuals’ lives.
“Almost everyone I know in
Uganda has a friend or relative
affected by the disease,” Senk-omago
said.
Tellus Leadership Scholar-ships
worth up to $75,000 are
awarded to remarkable, com-mitted
students from tradi-tionally
underserved countries.
“Virginia’s proven academic
performance and her clinical
work in the DRC fit perfectly
with the Foundation’s goals,”
said Andrew Waters, president
of the Tellus Educational Foun-dation.
“We are thrilled that she
is a Tellus Leadership Scholar.”
“I want to use my knowledge
to enhance the well-being of
others,” Senkomago said. “The
Tellus scholarship allows me to
do this, and I’m so grateful for
the Foundation’s support.” n
–Natalie Gott
Bequests are a vital source of support for UNC Gillings
School of Global Public Health. Bequests:
• Create scholarships,
• Establish professorships,
• Build new facilities,
• Support research and
• Improve the public’s health.
The School’s continued excellence in research, teaching
and service depends upon you —our friends and alumni
who remember the School in their estate plans. Now —
more than ever —your bequest makes a difference.
Contact us today about including UNC Gillings School
of Global Public Health in your estate plans. For more
information, check the appropriate box in the enclosed
envelope, or contact:
Lyne S. Gamble Jr.
Director of Major and Planned Gifts
UNC Gillings School of Global Public Health
Campus Box 7407, 135 Dauer Dr.
Chapel Hill, N.C. 27599-7407
lyne_gamble@unc.edu
919.966.8368
Your Gift Today...
a healthier
tomorrow
Senkomago selected
for Tellus Educational
Foundation Scholarship
Virginia Senkomago
L inda Kastleman
L inda Kastleman
Master’s student Patsy Polston (right) is shown here with her
adviser, Dr. Jill Stewart.
c a r o l i n a p u b l i c h e a l t h | 35
Donor s
Pharmaceutical company sanofi-aventis is sponsoring a new
Department of Nutrition scholarship program that will help
bring top international doctoral students to UNC Gillings School
of Global Public Health.
Through the sanofi-aventis—UNC Global Nutrition Scholars
Program, the company will fund half the cost of a five-year doc-toral
program for three international students, or about $410,000.
The company’s sponsorship will be matched with funds from the
UNC Graduate School, the Department of Nutrition and faculty
funding sources.
“We’re trying to think more globally in our research and nutri-tion
programming,” said June Stevens, PhD, department chair. “This
is a great step forward in accomplishing that goal.”
Stevens says that the economic downturn has meant many quali-fied
and enthusiastic international students have not been able to
attend UNC. The scholarship will make that opportunity possible
and will prepare more students to address nutrition and other health
challenges around the world.
The first Scholars will arrive at UNC in fall 2010. After their
first year of study, they will have the unique opportunity to develop
skills and broaden their understanding of the global pharmaceutical
industry through an internship with sanofi-aventis U.S. n
More than 300 alumni
and friends of UNC’s
biostatistics department came
to Chapel Hill, N.C., on Oct.
12, 2009, to celebrate the
department’s 60th anniversary.
A series of presentations
illuminated the department’s
distinguished history, and
attendees from as far away as
Brazil shared remembrances
about their experiences in
Chapel Hill. The multiple-day
event was a happy mix of schol-arship
and friendship.
“A key theme that emerged
in our celebrations and presen-tations
was the invaluable role
of the student-mentor relation-ship,”
said Michael Kosorok,
PhD, professor and chair in the
department.
“We were all moved at
how many of these relation-ships
stay vibrant and alive,
beyond campus walls and past
graduation.”
A fitting emblem of that
phenomenon, Kosorok said,
is Gary Koch, PhD, whose
Festschrift* was a highlight
of the celebration. Colleagues
and former students presented
lectures and testimonials to
honor the longtime professor’s
achievements. A special issue
of the journal Statistics in Bio-pharmaceutical
Research, to
appear in late 2010 or 2011,
will include scientific articles
honoring Koch.
One of the celebratory
events was a breakfast for Law-rence
Kupper, PhD, Alumni
Distinguished Professor of bio-statistics,
who retires in 2010
after 40 years on the UNC
faculty.
The department was estab-lished
in 1949, under the
leadership of inaugural chair
Bernard Greenberg, PhD.
Greenberg chaired the depart-ment
until he became dean of
the UNC public health school
in 1972.
A gallery of photogra

Innovations to improve
the public’s health
Thinking Big
SPRING 2 0 1 0
volume 1 · number 8
Dennis Gillings, CBE, PhD, Chair
Chairman and Chief Executive Officer
Quintiles
Marcia A. Angle, MD, MPH
Adjunct Professor
Nicholas School of the Environment
Duke University
William K. Atkinson, PhD, MPH
President and Chief Executive Officer
WakeMed
Joseph Carsanaro, MBA, MSEE
General Manager
Pinehurst Advisors LLC
Gail H. Cassell, PhD, DSc (hon)
Vice President, Scientific Affairs and
Distinguished Lilly Research Scholar
for Infectious Diseases
Eli Lilly and Company
Willard Cates Jr., MD, MPH
President, Research
Family Health International
Susanne Glen Moulton, JD, MPH,
President
Director
Patient Assistance and Reimbursement
Programs
GlaxoSmithKline
Jack E. Wilson, PE, MSENV,
Vice President
Board of Directors
TEC Incorporated
Delton Atkinson, MPH, MPH, PMP
Deputy Director
Division of Vital Statistics, National
Center for Health Statistics
Centers for Disease Control and
Prevention
David J. Ballard, MD, MSPH, PhD,
FACP
Senior Vice President and Chief Quality
Officer
Baylor Health Care System
Executive Director and BHCS Endowed
Chair
Institute for Health Care Research and
Improvement
Andrea Bazán, MPH, MSW
President
Triangle Community Foundation
Fred T. Brown Jr., MPH, FACHE
Managing Director
Business Development
Carolinas HealthCare System
Kelly B. Browning, MA
Executive Vice President
American Institute for Cancer Research
Deniese M. Chaney, MPH
Partner
Accenture Health and Life Sciences
Andrew Conrad, PhD
Chief Scientific Officer
National Genetics Institute
Keith Crisco, MBA
Secretary of Commerce
State of North Carolina
Nancy A. Dreyer, PhD, MPH
Chief of Scientific Affairs
OUTCOME
Ken Eudy
Chief Executive Officer
Capstrat
Robert J. Greczyn Jr., MPH
Chief Executive Officer Emeritus
BlueCross and BlueShield of North
Carolina
James R. Hendricks Jr., MS
Vice President of Environment, Health
and Safety (Retired)
Duke Energy
Stacy-Ann Christian, JD, MPH
Senior Director
Research Administration
New York City Health and Hospital
Corporation
Michael (Trey) A. Crabb III, MHA,
MBA
Managing Principal - Nashville
Stroudwater Associates
Leah Devlin, DDS, MPH
Gillings Visiting Professor
UNC Gillings School of Global Public
Health
Carolina Public Health Solutions
Cynthia J. Girman, DrPH
Senior Director
Department of Epidemiology
Merck Research Laboratories
Sandra W. Green, MBA, MHA,
BSPH
President, East Coast Customer
Management Group
MedAssets Incorporated
C. David Hardison, PhD
Corporate Vice President
Life Sciences
Science Applications International
Corporation
Deborah Parham Hopson, PhD,
RN
Assistant Surgeon General
Associate Administrator
HIV/AIDS Bureau
Health Resources and Services
Administration
J. Douglas Holladay, MDiv
Chairman and Chief Executive Officer
PathNorth
Donald A. Holzworth, MS
Chairman
Futures Group International
David P. King
President and Chief Executive Officer
Laboratory Corporation of America
A. Dennis McBride, MD, MPH
Health Director
City of Milford (Conn.)
John McConnell
Chief Executive Officer
McConnell Golf
Guy Miller, MD, PhD
Chairman and Chief Executive Officer
Edison Pharmaceuticals Incorporated
James Patrick O’Connell, PhD, MPH
Chief Executive Officer
Acea Biosciences Incorporated
Joan C. Huntley, PhD, MPH
Adjunct Professor of Epidemiology
UNC Gillings School of Global Public
Health
Mark H. Merrill, MSPH
President and Chief Executive Officer
Valley Health System
Stephen A. Morse, MSPH, PhD
Associate Director for Environmental
Microbiology
National Center for the Prevention,
Detection, and Control of Infectious
Diseases
Centers for Disease Control and
Prevention
Douglas M. Owen, PE, BCEE
Vice President
Malcolm Pirnie Incorporated
Jonathan J. Pullin, MS
President and Chief Executive Officer
The Environmental Group of the
Carolinas Inc.
Roy J. Ramthun, MSPH
President
HSA Consulting Services LLC
Jacky Ann Rosati, PhD
Environmental Scientist and
Containment Area Lead
U.S. Environmental Protection
Agency
National Homeland Security
Research Center
Ilene C. Siegler, PhD, MPH
Professor of Medical Psychology
Duke University
Carmen Hooker Odom, MS
President
Milbank Memorial Fund
Jane Smith Patterson
Executive Director
The e-NC Authority
Joan Siefert Rose, MPH
President
Council for Entrepreneurial
Development
Virginia B. Sall
Co-Founder and Director
Sall Family Foundation
Charles A. Sanders, MD
Chairman and Chief Executive Officer
(Retired)
Glaxo Incorporated
Paul M. Wiles, MHA
President and Chief Executive Officer
Novant Health Incorporated
Jeffrey B. Smith, MHA, CPA
Partner
Ernst & Young LLP
Paula Brown Stafford, MPH
Executive Vice President
Integrated Clinical Services
Quintiles Transnational Corporation
Russell B. Toal, MPH
Clinical Associate Professor
Health Policy and Management
Jiann-Ping Hsu College of Public
Health
Georgia Southern University
John C. Triplett, MD, MPH
Regional Medical Officer
Bethesda, Md.
G. Robert Weedon, DVM, MPH
Veterinary Outreach Coordinator
Alliance for Rabies Control
Adjunct Faculty
UNC-Wilmington
Veterinarian
New Hanover County (N.C.) Board
of Health
Alice D. White, PhD
Vice President
Worldwide Epidemiology Department
GlaxoSmithKline
Thomas K. Wong, PhD
Vice President
Meganium Corporation
Public Health Foundation, Incorporated BOARD OF DIRECTORS
UNC Gillings School of Global Public Health ADVISORY COUNCIL
c a r o l i n a p u b l i c h e a l t h | 1
contents spring 2010
3 Innovation matters!
4 Bright ideas, right partners, insightful solutions
6 No sugar-coating the crusade against obesity
9 Flu viruses move fast—so do public health officials
10 Going Viral
11 Harnessing vast data to understand COPD
13 ‘Team Science’ advances technology
14 UNC and UAE partner to protect environment
16 Peers for Progress
17 Water power—bringing streams together to make a mighty river
18 How the World Learns
20 Tracking Tropical Disease
21 Converting hog waste into energy
23 Unraveling the mystery of arsenic’s modi operandi
features & news
continued 8
4
6
17
11
21
2 | SPRING 2 0 1 0
24 Safety first on the job, especially for
inexperienced teens
25 Putting new ideas where their mouths are
26 school news
29 in memoriam
30 awards and recognitions
33 New cervical cancer initiative aims to save lives
33 Allison composes song to celebrate School
34 Senkomago selected for Tellus Educational
Foundation Scholarship program
35 Sanofi-aventis to sponsor new Department of
Nutrition scholarship program
35 biOS turns 60!
36 One generous turn inspires another
Delton atkinson, mph: champion of diversity
contents, continued 29
spring 2010 Dean
Barbara K. Rimer, DrPH
director of communications
managing editor
Ramona DuBose
editor
Linda Kastleman
Associate Dean for
External Affairs
Peggy Dean Glenn
Design and Production
Karen Hibbert
UNC Design Services
Contributing Writers
Jay Cartwright, Ramona DuBose,
Natalie Gott, Linda Kastleman,
Kathleen Kearns, Chris Perry, Susan
Shackelford and Angela Spivey
illustrations
Karen Hibbert
Articles appearing in Carolina
Public Health may be reprinted with
permission from the editor. Send
correspondence to Editor, Carolina
Public Health, Gillings School of
Global Public Health, Campus Box
7400, Chapel Hill, NC 27599-7400, or
e-mail sphcomm@listserv.unc.edu.
Subscribe to
Carolina Public Health
www.sph.unc.edu/cph
17,000 copies of this document were
printed at a cost of $11,397 or $0.67
per copy.
Carolina Public Health (ISSN 1938-
2790) is published twice yearly by the
UNC Gillings School of Global Public
Health, 135 Dauer Dr., Campus Box
7400, University of North Carolina at
Chapel Hill, Chapel Hill, NC 27599-
7400. Vol. 1, No. 8, Spring 2010.
our donors
24 25
back page
c a r o l i n a p u b l i c h e a l t h | 3
Innovation refers both to some new thing—a prod-uct,
program or idea thought to be an improvement
over what preceded it—and a process of getting the
thing into practice. In public health, especially in our
School, we aim to solve some of the world’s greatest
problems—providing safe water to people who lack
it, helping to change unhealthy behaviors, such as
smoking and poor diets, reducing errors in operating
rooms and pharmacies, and developing better ways
to conduct clinical trials. Too many interventions are
cumbersome, costly or culturally inappropriate. We
need practical, practicable and scalable innovations
that are transformative. Some inspiring examples
from our School include:
• Mark Sobsey, PhD, and colleagues designed a
much improved ceramic water filter. A crucial
test is its adoption on a scale large enough to
make a difference.
• Repellent-treated mosquito bed nets are an
important innovation. Faculty members,
including Drs. Frieda Behets, Andrea Biddle,
Steve Meshnick, Audrey Pettifor and Annelies
Van Rie, conduct field studies to ensure that
nets are adopted in practice.
• Noel Brewer, PhD, and Jennifer Smith, PhD, are
among the first to study how new vaccines to
prevent HPV are being adopted.
• The Safe Dates program, developed by Vangie
Foshee, PhD, and colleagues, is more effective
than previous programs; it now is being used
around the country.
• Deborah Tate, PhD, was one of the first to take
dietary counseling online.
• Marci Campbell, PhD, was awarded an NIH
Challenge Grant for her novel use of micro-finance
and health behavior interventions to
improve diets in eastern North Carolina.
• Sue Havala Hobbs, DrPH, and Ned Brooks,
DrPH, created a new hybrid-model executive
Doctor of Public Health program that allows stu-dents
to keep working while earning a doctorate.
We have funded 18 Gillings Innovation Labo-ratories
to solve big public health problems and
accelerate solutions. The range of programs, from
development of new laboratory tests to new ways of
encouraging use of local foods, is impressive.
Many innovations are worthy of adoption. Yet,
we know that the process of adopting public health
innovation is painfully slow; people die waiting. Sev-eral
faculty members, including Alice Ammerman,
DrPH, Cathy Melvin, PhD, and Bryan Weiner, PhD,
focus on speeding adoption of innovations.
Our faculty, staff, students and partners are
creating ideas, programs, tests and tools to improve
the public’s health and translate effective programs
into practice. Together, we bring life to public health
“innovation.” It’s a matter of health!
Innovation Matters!
UNC Chancellor Holden Thorp wants Carolina to be an innovation hub. As
leader of a great public university and a scientist known for chemistry inventions,
Thorp understands that innovations play a critical role in improving health and
society. In this issue of Carolina Public Health, we investigate innovation’s role in
our School and its broader implications for public health.
Dr. Barbara K. Rimer
from the Dean’s desk
To him who devotes his life to science,
nothing can give more happiness than
increasing the number of discoveries, but his
cup of joy is full when the results of his studies
immediately find practical applications.
–Louis Pasteur
L isa Marie Albert
Note: Rimer also participates in a roundtable discussion about innovation on pages 4–5.
4 | SPRING 2 0 1 0
Bright ideas,
right partners,
insightful solutions
In this century, public health researchers
could discover more advances—preventives
for cancers, new ways to heal and protect
the environment, effective means to prevent
obesity and more efficient ways to provide
health care for all.
“Innovation in public health brings hope
to all humankind—hope that our children
and our children's children will live healthier,
higher-quality lives without much of the suf-fering
that seems so prevalent in our world
today,” says Dennis Gillings, CBE, PhD, chair
and chief executive officer of Quintiles and
chair of the School’s Advisory Council.
Innovation is fundamental at the UNC
Gillings School of Global Public Health. This
issue of Carolina Public Health is dedicated to
the outstanding efforts of faculty, students,
staff and alumni who are searching for more
effective vaccines for tougher diseases (see
page 10), finding better ways to provide
clean water throughout the world (see page
17), waging war against obesity (see page 6),
and fighting pollution, cancer and infectious
diseases.
In January 2010, members of the UNC-Chapel
Hill Chancellor’s Innovation Circle
visited the School to hear about some of our
researchers’ innovative solutions to water
problems facing the world. The circle is an
advisory council of respected UNC alumni
and friends charged with helping to develop
a roadmap for a culture of systematic
innovation and entrepreneurship
at Carolina. It is chaired by
Lowry Caudill, PhD, a 1979
UNC graduate and co-founder
of Magellan Laboratories Inc. After
the visit, Caudill said he and other circle
members were impressed with research being
done at the School.
“Chancellor Thorp’s vision is to transform
new knowledge in the university for maxi-mum
societal benefit,” Caudill said. “The
(Gillings) School of (Global) Public Health is
doing this already and doing it really, really
well. I made the point later in the afternoon
to the whole group that as we look for best
practices at other schools like Stanford and
MIT, we need to look in our own backyard
at the School of Public Health.”
So what is innovation?
“Innovation is all about creating things,”
said Don Holzworth, chair of Futures Group
International and the School’s Gillings
Executive in Residence. “It’s about joining
ideas that haven’t been joined before, which
Vaccines for diseases such as polio and smallpox,
fluoridation of drinking water, prenatal care and
use of vitamin A to prevent blindness all are public
health innovations. So are seat belt laws, clean drink-ing
water, modern sanitation requirements and cam-paigns
against abuse of drugs, alcohol and tobacco.
f e at u r e s a n d n ews
ultimately leads to a breakthrough or a more
efficient way of delivering something we
already know about.”
Innovation often comes when people with
different perspectives join forces to solve a
problem.
“The ‘outsider’s perspective’ can stimulate
new ideas,” Holzworth said. “It’s disruptive
thinking, but it’s constructive disruption.”
The UNC Gillings School of Global Public
Health is partnering with different depart-ments,
universities, government agencies
(domestic and foreign), nongovernmental
organizations, companies and individuals.
For example, UNC biostatistics researchers
now work with researchers at Duke and N.C.
State universities to find ways to design more
powerful clinical trials for cancer treatments.
Their work is funded through a $12.5 million
grant from the National Cancer Institute
(see page 26). UNC public health research-ers
also have teamed up with officials and
academicians in the United Arab Emirates
and with Rand Corporation and others to
assess environmental and public health risks
accelerated by development and to establish
a national strategy for addressing those risks
(see page 14).
“Because everyone’s resources are so lim-ited,
it’s more important now than ever
before to be creative and work with partners
we’ve never worked with before,” said Leah
Devlin, DDS, Gillings Visiting Professor and
former North Carolina state health director.
Devlin lauds the School’s efforts, espe-cially
through the N.C. Institute for Public
Health (NCIPH), to work with the state’s
Department of Health and Human Services
and with local health departments through-out
North Carolina.
“We are the only state in the country that
requires accreditation of our health depart-ments
to establish consistent standards,”
she said.
Jane Smith Patterson, executive director of
e-NC Authority and member of the School’s
Advisory Council, echoes Devlin’s enthusi-asm
for how the state and the university can
enhance each other’s work.
“By matching public health needs with
the knowledge of university public health
researchers and public health practitioners,
there is an amazing opportunity to develop
innovative programs and practices that can
be…taken to scale in close to real time,”
she said.
But not every innovation is an improve-ment,
cautions Barbara K. Rimer, DrPH,
dean and Alumni Distinguished Professor
at the School.
“In 2005, for example, biostatistics profes-sor
Ed Davis, PhD, and others found that new
medicines to treat schizophrenia were not
better than their predecessors, cost more and
caused more side effects,” she said.
“This comparative effectiveness research
is essential. We must know when newer is
not better.”
Innovations are more than inventions,
Rimer said.
“We care about innovations because in
public health, and especially in our School,
we aim to solve some of the world’s greatest
problems. We must be willing to look at how
we have done things before and ask whether
there are other, better ways to do a thing. We
want to create the ideas, programs, tests and
tools that make the world better. Those are
public health products, and they are happen-ing
right here, at our School.”
And they’re making a difference.
“Public health investment and dedication
by our university are making the difference
and will continue to do so,” Gillings said.
“Moreover, prevention promises huge
breakthroughs, particularly if we can impact
selective behavior patterns in cost-effective
ways. I am excited about our opportunity and
applaud our dedicated researchers for their
motivation and devotion to improving the
health of us all.”
–Ramona DuBose
Innovation is all about creating things …
It’s about joining ideas that haven’t been
joined before, which ultimately leads to a
breakthrough or a more efficient way of
delivering something we already know about.
–Don Holzworth
c a r o l i n a p u b l i c h e a l t h | 5
6 | SPRING 2 0 1 0
f e at u r e s a n d n ews
But Popkin, an internationally recognized
expert in nutrition and obesity, is unfazed.
Savvy, passionate and eager to speak out,
he says, “I want to have an impact.”
The Carla Smith Chamblee Distinguished
Professor of Global Nutrition in the Uni-versity
of North Carolina’s Gillings School
of Global Public Health and director of
the UNC interdisciplinary obesity program
makes an impact often.
You may have seen his comments in The
New York Times or Time magazine or heard
him on National Public Radio or Al Jazeera.
He’s such a seasoned media source that he
might show up for a satellite inter-view
at the UNC television stu-dios
in a shirt and tie—and shorts
and sandals. He knows he’ll be
visible only from the waist up.
Now 66, Popkin was among
the first researchers to start track-ing
the effects of diet and activ-ity.
His data are based on four
decades of observation of indi-viduals,
households and com-munities,
from Russia to Mexico
and China to Brazil. The worst
problems used to be hunger and
malnourishment. Now, obesity is
epidemic in both developed and
developing countries.
He says sugar-sweetened beverages are to
blame for much of the weight gain. “You are
what you drink,” he says. In 1960, the aver-age
American consumed 100 to 200 calories
a day in beverages. Today, the figure is 500
calories.
In 2005, Popkin assembled leading nutri-tion
experts from Johns Hopkins, Harvard,
Louisiana State and Oregon State universi-ties,
and other institutions, to study available
literature and provide guidance on risks and
benefits of various beverage categories. Their
results were published in The American Jour-nal
of Clinical Nutrition in 2006.
“The Beverage Guidance Panel that Barry
convened produced a first of its kind—a
guide for the kinds of beverages that have the
best value for your health,” says George Bray,
MD, Boyd Professor and chief of the division
of clinical obesity and metabolism at the
Pennington Biomedical Research Center in
Baton Rouge, La., and a member of the panel.
Now, Popkin works with governments
around the world to establish beverage guide-line
policies.
“France and the U.K. have banned caloric
beverages in schools,” he says. “Mexico has
created beverage guidelines, and now I am
working with the U.K. and China on this topic.”
In the U.S., he advocates a tax on sugar-sweetened
beverages to discourage people
from drinking them, he says. He and six
other scholars wrote a 2009 report in The
New England Journal of Medicine that advo-cated
a consumer tax of one percent per
No sugar-coating the
crusade against obesity
When Barry Popkin, PhD, advocates for a
national tax on sugar-sweetened beverages,
soft-drink makers and food-industry groups attack.
“Everybody comes after me,” he says.
All Ages
Percentage of daily caloric intake from beverage, by age group
0
5
10
15
20
% 25
Age 2-18 19-39 40-59 60+
Other milk beverages
Coffee and tea
Alcohol
Fruit juice
Milk
Fruit drinks
Soft drinks
c a r o l i n a p u b l i c h e a l t h | 7
ounce on sugar-sweetened beverages both
to reduce consumption and bring in money
to support health programs, as tobacco taxes
have done. His latest study, published March
9, 2010, in Archives of Internal Medicine,
shows that people eat less fast food, such as
pizza and burgers, when the prices go up,
supporting his proposal to tax these foods
in addition to sugar-sweetened beverages.
Not surprisingly, soft-drink makers,
supermarket companies, the fast-food indus-try
and other groups poured more than $24
million into the coffers of Washington lobby-ists
in the first nine months of 2009 to fight a
potential national tax and other regulations,
according to The Huffington Post.
Popkin’s recent book, The World is Fat:
The Fads, Trends, Policies and Products that
are Fattening the Human Race, draws on what
he’s learned throughout his
career. He makes a strong
case that lifestyle changes,
including eating more sug-ary
and fatty foods, as well
as government policies and
globalized food marketing,
are fueling the weight gain.
“How we eat, drink and
move has changed so drasti-cally
in the last 60 years,” he
says. “Our biology clashes
with modern marketing and
technology.”
His research exam-ines
health implications of
those policies and lifestyle
changes, and his findings
have been published in more
than 300 articles in peer-reviewed
journals, including
The New England Journal of
Medicine, Journal of the American Medical
Association, Science, Obesity, Circulation and
the American Journal of Clinical Nutrition.
His research covers the whole spectrum of
life—for example, he’s published articles
in both Pediatrics and the Journal of Nutri-tion
of the Elderly. His work has appeared
in renowned peer-reviewed publications in
Europe, China, the Philippines and the Asia-
Pacific region.
His most innovative work, say colleagues,
has been developing the concept of “Nutri-tion
Transition,” a way of understanding
long-term nutritional status changes by look-ing
at shifts in the stages of eating, drinking
and activity, underlying societal shifts and
resulting effects on body composition.
He also has pioneered large longitudinal
studies around the world, including ones in
China, Russia and the Philippines. He’s led
related studies in Brazil, Mexico and other
countries, studying some populations for
four decades. “When I came into the field,
such studies were not a focus,” he says.
His work has played a major role in estab-lishing
databases for scholars to study diet
and activity. More than 10,000 researchers
have downloaded his longitudinal studies.
Dr. Barry Popkin takes personally his professional campaign for good health,
regularly biking to campus for exercise. (Note: Popkin removed his helmet to
pose for the photo, but he never bikes without it.)
Popkin says sugar-sweetened beverages are
to blame for much of the weight gain.
“You are what you drink.”
8
l inda kastleman
f e at u r e s a n d n ews
8 | SPRING 2 0 1 0
“Barry has made many important con-tributions
to nutrition research,” says Penny
Gordon-Larsen, PhD, UNC associate profes-sor
of nutrition, who has published several
articles with Popkin. “He is probably most well
known for his work on the nutrition transi-tion
and global obesity. Yet he also has made
major contributions in investigations on the
role of dietary fat in obesity, sugar-sweetened
beverages and obesity, health disparities, and
economic determinants of diet and obesity.”
Popkin—tall, wiry and agile—attacks
obesity many different ways. On a personal
level, he rides his bike to work and around
town. He is part of an international board
of scientists helping to develop simple front-of-
the-package labels in European countries,
Israel and India. He’s working with the
Mexican Ministry of Health and Finance to
develop a similar program in that country.
He also has waded into the U.S. Food and
Drug Administration’s review of nutrition
labeling guidelines. In the Feb. 8 issue of The
New York Times, he wrote: “Placing compli-cated
labeling on the back of the package simply
does not work. Studies from the Netherlands,
the U.S. and elsewhere have found that system
to be confusing and that it does little to affect
consumer decisions. Front-of-the-package
labeling, which has emerged in the past three
to four years, promises to be more effective.”
But he doesn’t stop there.
“We also need to remove all false advertis-ing
that says ‘contains antioxidants’ and tries
to connote that a product is ‘heart healthy’
when there is no reality to that claim,” he
writes. “We need ways to stop food manufac-turers
from making misleading claims, and
we need scientists independent of the food
industry to set healthy guidelines for various
food categories.”
No wonder he’s a target.
However, he also tries to reach out to the
food and beverage industry, encouraging
them to be part of the solution to obesity. In
2007, he started an annual “Global Obesity
Business Forum” with senior executives
from food, beverage and infant formula
companies. The meetings are private, Popkin
says, so the executives can be frank and open
about their concerns and processes.
As a college student in the 1960s, Popkin
was active in the civil rights movement nation-ally
and in his home state of Wisconsin. Those
experiences, he said, taught him to take the
slings and arrows of criticism in stride. “There
were people who loved you, and people who
hated you,” Popkin says. “That’s the way it is
when you’re fighting for a cause.” n
–Susan Shackelford
SWEETENED
BEVERAGES
[20 oz.]
SWEETENED
BEVERAGES WITH
NO CALORIES [5 oz.]
LOW FAT
MILK [3 oz.]
SWEETENED
BEVERAGES WITH
NUTRIENTS [15 oz.]
TEA/COFFEE
UNSWEETENED [15 oz.]
WATER
[46 oz.]
FLUID OUNCES
Total = 104
SWEETENED
BEVERAGES
[20 oz.]
SWEETENED
BEVERAGES WITH
NO CALORIES [5 oz.]
LOW FAT
MILK [3 oz.]
SWEETENED
BEVERAGES WITH
NUTRIENTS [15 oz.]
TEA/COFFEE
UNSWEETENED [15 oz.]
WATER
[46 oz.]
SWEETENED
BEVERAGES
[211 calories]
SWEETENED
BEVERAGES WITH
NO CALORIES [1 cal.]
TEA/COFFEE
UNSWEETENED [11 cal.]
WATER [0 calories]
CALORIES
Total = 464
SWEETENED
BEVERAGES WITH
SOME NUTRIENTS
[213 calories]
LOW FAT MILK [29 calories]
FLUID OUNCES
Total = 104
Americans drink too much and drink unhealthily.
These figures show the beverage intake pattern
of adults in the U.S., in volume and calories.
Drinking 35 oz. of sweetened beverages in a
day (out of a total 104 oz.) accounts for about
half of the calories consumed from beverages.
Popkin’s Beverage Panel suggests the average
adult might best consume 98 oz. in beverage
each day, including up to 50 oz. of water and no
sweetened beverage without nutrients.
Dr. Barry Popkin is a frequent guest at Carolina News Studio, giving interviews that are
broadcast around the world.
l inda kastleman
c a r o l i n a p u b l i c h e a l t h | 9
They wanted to determine what people knew
about the vaccine and how many were plan-ning
to get immunized. And they needed to
know fast.
They found help at the N.C. Center for
Public Health Preparedness at UNC Gill-ings
School of Global Public Health’s N.C.
Institute for Public Health. Jennifer Horney,
PhD, research assistant professor of epide-miology
and deputy director at the center,
partnered with UNC public health school
alumnus Aaron Fleischauer, PhD, a com-mander
with the U.S. Public Health Service
stationed at the N.C. Department of Health
and Human Services in Raleigh, to launch a
rapid research project.
“For any preparedness effort, we want to
understand how the community perceives
the public health crisis so we can respond
better,” Fleischauer says.
In this case, telephone interviews weren’t
sufficient. Twenty percent of people in
the U.S. have replaced land lines with
cell phones, and one of the groups at
highest risk for the H1N1 virus—
people aged 18 to 25 years—are
among those most likely to be
missed by a traditional phone sur-vey.
The team decided to conduct
in-person interviews, choosing a
two-stage random sample that employed the
use of parcel maps and geographic informa-tion
systems.
“Interviewers use a hand-held computer
with a GPS navigational tool that gives them
a map and printed directions that send them
to a random point. Then they go to the house
that’s nearest that point and conduct an
interview,” Horney explains.
A team of 20—including state personnel,
UNC faculty members and student volun-teers—
conducted 207 interviews with people
aged 18 to 92 from two North Carolina coun-ties,
Orange and Alamance. The population-based
sampling method yielded interviews
that would be representative of all the people
who live in those counties, Horney says.
The study showed that, at least in these
counties, people may not have been receiv-ing
the state’s communications about H1N1,
which were mostly online. Only a third of the
people in the study said they typically
found news and information on the
Internet, while 83 percent depended
upon television.
“It was a big surprise to us that
most people (in these counties) were
still getting news from television,
and even printed newspapers, which
were the second most common source
of information,” Horney says. Also, most
people in the survey were unaware that the
vaccine would be given in two doses, which
was the plan at the time of the survey.
These findings helped the state create bet-ter
and more targeted messages.
“Once we learned there were pieces of
information that the community wasn’t
getting, we made special efforts to get it to
them,” Fleischauer says.
The study also showed a greater-than-expected
potential demand for the vaccine,
with 63 percent of respondents saying they
planned to get vaccinated. The one previous
study regarding H1N1 perceptions—a national
Internet survey from Rand Corporation—had
showed that only 50 percent of people planned
to do so. If time and funds are available,
Horney aims to follow up in spring 2010, to
find out what percentage of North Carolinians
got vaccinated. n
–Angela Spivey
The N.C. Center for Public Health Preparedness is
part of a national network of preparedness centers
funded by the Centers for Disease Control and
Prevention (CDC). The study was funded by the
Robert Wood Johnson Foundation, and results
were published in the Dec. 25, 2009, edition of the
CDC’s Morbidity and Mortality Weekly Report
(MMWR). See http://snipurl.com/mmwr-flu.
Flu viruses move fast—
so do public health officials
preparing for pandemic
In August 2009, two months before the first
shipment of H1N1 vaccine was to arrive in North
Carolina, officials with the N.C. Division of Public
Health already were planning how to distribute it. Dr. Jennifer Horney
wil l owens
f e at u r e s a n d n ews
10 | SPRING 2 0 1 0
After all, he’s the epidemiology professor
who synthetically reproduced the variant
of the SARS virus found in bats—probably
the species from which the deadly human
version emerged.
“Only three other teams of researchers
have synthetically reconstructed a virus,” he
said when his research was published in the
Proceedings of the National Academy of Sci-ence.
“It will provide a model to understand
the means and ease by which animal corona-viruses
move from one species to another.”
Baric and his team of researchers at UNC
Gillings School of Global Public Health are
world leaders in coronavirus research. This
type of RNA virus is responsible not only for
SARS but also for other types of childhood
pneumonia and even the common cold.
“The lab has rewired the coronavirus
genome—taking out the natural regulatory
signals and rewiring them with synthetic
signals,” explains Eric Donaldson, PhD,
research assistant professor of epidemiology.
“This prevents the rewired virus from
recombining with natural strains of the virus
and prevents reversion of vaccine strains
into more dangerous strains. However, the
rewired virus still causes a similar immune
response in the body.”
Baric and his team were awarded a Gill-ings
Innovation Lab (GIL) to develop a low-cost,
single-dose vaccine against respiratory
illness in children living in develop-ing
countries. This vaccine would
treat influenza, RSV and measles;
be stable at room temperature; and
inhaled, rather than given with a
needle. If they are successful, their
work could lead to a new approach
for designing and administering
other global health vaccines.
“No one has ever successfully
delivered three antigens from three
different highly pathogenic respiratory
viruses simultaneously in a highly portable
platform that would be affordable and easy to
use in the developing world,” Baric said after
receiving his GIL.
Any of these three projects—the synthetic
reproduction of SARS, the genetic rewir-ing
of coronavirus or the multivalent vac-cine—
could yield astounding stories about
innovation. But Baric wanted to focus on yet
another innovative project.
“Let’s talk about norovirus,��� he suggested.
Noroviruses are those nasty little bugs
that cause great misery—48 to 72 hours of
vomiting and/or diarrhea in healthy adults. In
infants and the elderly, the virus can be fatal.
“It only takes a few virus particles from
respiratory droplets or fecal contamination
to cause explosive transmission of the disease,
especially in isolated communities,” he said.
In communities such as retirement homes,
college dormitories, military installations,
cruise ships and even airplanes, the infection
can have devastating results.
People can acquire norovirus infections
more than once in a season.
“It’s been thought that the body’s immune
response to norovirus infection is short-lived,
and that’s why people become reinfected,”
Baric said. “We don’t believe that this rep-resents
the whole story. We think the virus
is changing rapidly, so the body’s immune
Going viral
From SARS to the common cold,
Baric’s research could lead to vaccines
An issue of Carolina Public Health on innovation
would be incomplete without an article on
Ralph Baric, PhD, and his work with viruses.
Lisa Lindesmith, an epidemiology
research specialist at the School,
studies norovirus immunity in Dr.
Ralph Baric’s laboratory.
ramona dubose
system doesn’t recognize the new strain.”
The change is known as “antigenic
drift.” Immunity a person might have built
up to one variation of the virus is powerless
against the next strain. But Baric hopes
that by finding common elements of the
viruses’ genetic structure—and then caus-ing
the body to build immunity to those
elements—he can create a vaccine effective
against about 95 percent of the norovirus
strains that infect humans.
“His work, although still with mice, has
shown there is a way to develop effective
vaccines against these viruses, even though
you have to cover quite a few genetic types,”
said Jan Vinjé, PhD, norovirus team leader
in the Gastroenteritis and Respiratory
Viruses Laboratory Branch of the U.S. Cen-ters
for Disease Control and Prevention.
“[Baric] brings a fresh, new perspective
to the field,” Vinjé said.
Lisa Lindesmith, an epidemiology
research specialist who’s been working
with Baric for 10 years, agrees.
“We are moving the field from the idea
of short-term immunity. This is ground-breaking
work, and so is the coronavirus
work. It’s very rare for a lab to be so good
at two different things.” n
–Ramona DuBose
Dr. Ralph Baric’s innovative work with
viruses may lead to a portable, single-dose
vaccine to prevent respiratory illness
in children in developing countries.
ramona dubose
How do you capture and organize the infor-mation
a study like that generates? How do
you analyze all that complex data to make
it useful to those searching for treatments?
Through the groundbreaking methods of
UNC’s Collaborative Studies Coordinating
Center—that’s how.
Lisa LaVange, PhD, director of the CSCC
and professor of bio-statistics
at the UNC
Gillings School of
Global Public Health,
leads data collection
and analysis effort for
a project called SPI-ROMICS,
a nation-wide
study that aims
to help the more than
12 million people with chronic obstructive
pulmonary disease (COPD), a progressive
condition that makes breathing difficult.
SPIROMICS is short for SubPopulations
and InteRmediate Outcome Measures in
COPD Study. That mouthful of a moniker
indicates the project’s two goals: to identify
and better understand the various kinds
of COPD—known types include chronic
bronchitis and emphysema—and to discover
quicker ways to measure whether new treat-ments
will work. LaVange and her team won
a seven-year, $8 million contract from the
National Institutes of Health’s National Heart,
Lung and Blood Institute to serve as SPI-ROMICS’
Genomics and Informatics Center.
“It’s a real pan-campus research project,”
says LaVange. She believes the award came
to UNC because of its reputation for state-of-
the-art approaches to biostatistics, data
management and pulmonary research.
The Genomics and Informatics
Harnessing vast data to
understand COPD and
speed up new treatments
Ten clinics in six study centers. Thousands of
patients who suffer from a disease that has
multiple variations. Three years’ worth of clinical
and molecular data for each patient.
Dr. Lisa LaVange
8
c a r o l i n a p u b l i c h e a l t h | 11
12 | SPRING 2 0 1 0
f e at u r e s a n d n ews
Center draws together the expertise of Rich-ard
Boucher, MD, Claire Doerschuk, MD,
and Wanda O’Neal, PhD, at the UNC School
of Medicine; Jane Greenberg, PhD, and Javed
Mostafa, PhD, at the School of Information
and Library Science; and Fred Wright, PhD,
and Wei Sun, PhD, at the UNC Gillings
School of Global Public Health’s Department
of Biostatistics, where CSCC is based. The
CSCC team includes programmers, statisti-cians,
clinical monitors and project assistants
and is led by CSCC faculty member David
Couper, PhD, and project manager Betsy
Carretta. A fifth-generation, state-of-the-art
data management system, recently upgraded
to enhance data security and implement
industry-wide data standards, will be used
for the massive amounts of data to be col-lected
as part of the project.
Chronic obstructive pulmonary disease
is the fourth leading cause of death in the
United States, and currently no drugs bring
about long-term improvement. Study cen-ters
in Winston-Salem, N.C., Ann Arbor,
Mich., San Francisco, Los Angeles, New
York City and Salt Lake City will conduct
a wide range of clinical testing, collect bio-logical
specimens, and take both baseline
and follow-up radiological scans of more
than 3,200 patients.
“The fun comes when we start putting
clinical, radiological, molecular and biologi-cal
variables together,” says LaVange.
LaVange’s team will test specific hypoth-eses
about new subgroups of COPD patients.
“Not all people are affected by all forms of
COPD in the same way,” she explains.
“If we better understand the subtypes
of the disease, we can better target
patients for enrollment in clinical tri-als
designed to investigate a particular
therapeutic agent.”
The team also will identify biological,
clinical and radiological markers that
indicate how severe a patient’s disease is and
potentially can provide a sense of whether a
therapeutic agent is working or not. Clinical
trials to test new pharmaceuticals can take
years to complete, LaVange points out. Find-ing
markers that predict long-term outcomes
in a shorter period of time can accelerate the
development process and, combined with
more targeted patient enrollment, has the
potential to improve the chance of success in
future COPD clinical trials. n
–Kathleen Kearns
The fun comes when we start putting
clinical, radiological, molecular and
biological variables together.
At left, Dr. Richard Boucher examines a lung
tissue sample while Drs. Claire Doerschuk
and Wanda O’Neal look on. At right,
Doerschuk presents information about the
effect of chronic obstructive pulmonary
disease (COPD) on the human lung.
Project manager Betsy Carretta,
MPH (foreground), reviews materials
with SPIROMICS team members
including Dr. Patricia Basta (right),
co-director of the Biospecimen
Processing and Storage facility.
photos by l inda kastleman
l inda kastleman
c a r o l i n a p u b l i c h e a l t h | 13
What’s the right dose of a given drug? So
far, agencies charged with answering these
questions—the U.S. Environmental Protec-tion
Agency and Food and Drug Adminis-tration—
have not had good ways to account
for an immutable fact about human beings—
namely, that people are different.
Individual genetic makeup might keep
one person from metabolizing a given sub-stance,
while another might metabolize so
much that it becomes toxic. Ivan Rusyn, MD,
PhD, associate professor of environmental
sciences and engineering at UNC Gillings
School of Global Public Health and director
of the Carolina Center for Computational
Toxicology (CCCT), leads several projects
developing breakthrough methods to con-sider
genetic diversity. Research by Rusyn
and colleagues provides substantive data to
determine safe levels for pharmaceuticals
and environmental chemicals.
“Rapid advances in the technology of
genotyping make these types of studies pos-sible,”
Rusyn explains.
“Five or ten years ago, it was a major
undertaking to sequence one individual
mouse, yeast or human.”
Now, he says, researchers can quickly and
inexpensively sequence genetic information.
That means genetic data on many individuals
can be obtained easily.
It also means dealing with a staggering
amount of information.
“For some research, where we screen thou-sands
of compounds on hundreds of people,
we have millions of data points,” he says.
That’s where computational toxicology
comes in. The interdisciplinary field merges
toxicology, biology and computer science
to create new ways to synthesize data and
predict chemical hazards.
“Toxicologists need biostatisticians,
geneticists and molecular biologists to be
part of the team,” Rusyn says. “It’s team sci-ence,
and this campus is just great for build-ing
these teams.”
Fred Wright, PhD, professor of biostatis-tics,
is a key contributor to several research
efforts underway at CCCT. “Without his
help, we’d be dead in the water,” Rusyn says.
The teams don’t work on human popula-tions
per se, but on collections of human cells
from different individuals or on populations
of laboratory animals, such as mice.
“We’re using cell lines and exposing them
to different chemicals,” Rusyn says.
“We’re looking at whether different cell
lines respond differently, and if so, why. Simi-lar
experiments can be done in animal mod-els—
for example, in mice where we know the
genetic makeup of a particular strain. Having
in vitro and computational tools allows us to
address these risks without doing lengthy and
unnecessary animal research.”
The center’s col-laborative
approach
includes partnerships
with the EPA and the
National Institutes
of Health’s National
Institute of Environ-mental
Health Sci-ences,
National Toxicology Program and
National Chemical Genomics Center.
“We work with government stakeholders
to engage them in our research and leverage
resources and expertise,” Rusyn says.
Through this collaboration, he aims to
find reliable models to predict how individu-als
will react to chemicals and drugs. Rusyn
hopes that working directly with govern-ment
agencies also will speed up the flow of
information from the laboratory bench to the
regulator’s desk. n
–Kathleen Kearns
‘Team Science’
advances technology
Computational toxicology creates
new ways to synthesize data
How much exposure to a
certain chemical is safe?
Collaborative experiments with the National
Chemical Genomics Center are vital in gen-erating
data for Dr. Ivan Rusyn’s research.
Master’s student Shannon O’Shea (above, left)
and research specialist Oksana Kosyk traveled
to the center to expose dozens of cell lines
to various environmental chemicals, using the
center’s advanced robotic equipment (right).
Dr. Ivan Rusyn
photos by dr. menghang xia and sri sakamuru
14 | SPRING 2 0 1 0
Since June 2008, researchers at UNC Gill-ings
School of Global Public Health have
collaborated with UAE officials in an effort
to reduce and prevent such health challenges.
The UNC-UAE National Strategy for
Environmental Health project, sponsored by
the Environment Agency-Abu Dhabi, called
for UNC researchers to assess the country’s
greatest environmental risks and develop a
plan to strengthen the UAE’s public health
policy. UNC has partnered in that effort with
UAE University’s Department of Community
Medicine and with the RAND Corporation, a
global public policy research institution.
Researchers evaluated everything from
water quality, to food safety, to global climate
change. They found that outdoor air pollution
is the top environmental threat to the country,
followed by indoor air pollution and occu-pational
exposures. (Read the UAE project
report at www.sph.unc.edu/uae/report.)
Now, UNC epidemiologists are collecting
data to determine the effects that indoor pollut-ants,
diet and lifestyle have on Emiratis’ health.
The project is an opportunity to help UAE
officials manage environmental problems and
set the future course of environmental protec-tion,
said principal investigator Jacqueline
MacDonald Gibson, PhD, assistant professor
of environmental sciences and engineering.
It also serves as a bridge to rebuilding rela-tionships
in the Middle East, she said.
“After September 11 (2001), so much dam-age
was done to the relationship between the
U.S. and the Middle East that I thought we
needed to grab hold of this opportunity to
do constructive work in the Middle East,”
MacDonald Gibson said.
Ranking the risks
Once UNC researchers identified public
health threats facing the UAE, the next step
was to prioritize the needs for action. Com-mon
environmental risks do not always make
headlines, but they may be the biggest threat
facing a nation, MacDonald Gibson said.
Researchers worked with about 75 UAE
stakeholders to determine environmental
risk priorities.
UAE government officials, scholars and
representatives from industry and nongov-ernment
organizations participated in work-shops
to rank their priorities. Information on
each risk was provided in uniform summaries
that included details such as the fatalities the
risk was expected to cause in one year.
“Many of (the stakeholders) had never expe-rienced
a group process like that, and they felt
empowered that they had a chance to influence
their policy,” MacDonald Gibson said.
The project marked the first time this
process has been used on a national scale
to rank environmental risks. It has not
been employed in the United States because
policy here often is drafted after a disaster,
MacDonald Gibson said. However, the Army
Corps of Engineers is using the process to
assess risks along the Gulf Coast.
f e at u r e s a n d n ews
UNC and UAE
partner to protect
the environment
Rapid development in the United Arab
Emirates (UAE) has led to increased life
expectancy and greater economic opportunity, but
it also brings the potential for significant environ-mental
and public health threats.
Dr. Jacqueline MacDonald Gibson (right)
confers with colleague Rugaya Mohamed,
from the Environment Agency-Abu Dhabi.
Dr. pete andrews
The project marked the first time this process has been
used on a national scale to rank environmental risks.
Read the UAE project report at www.sph.unc.edu/uae/report.
c a r o l i n a p u b l i c h e a l t h | 15
Outdoor air quality
Outdoor air pollution is easily the greatest
threat to the 4.8 million people who live in
the UAE. UNC researchers estimate that 600
deaths each year can be attributed to outdoor
air pollution, with 540 of those due to par-ticulate
matter. Particulates include sand,
which can carry microbial fungi and other
infections, and result from diesel engines
used for massive construction, oil and gas
production, and car and barge traffic. Pol-lution
from Europe and Eastern Asia also
blows into the region.
To determine the UAE’s risk from outdoor
air pollution, scientists developed one of the
first air quality models in the region to simu-late
the atmosphere. The model stretched
beyond the UAE to the Arabian Peninsula
as far east as India, north into Turkey and
west to Cairo.
“We made the first state-of-the-art air
quality model for that part of the world,
and we created it using the most advanced
scientific methods and techniques available,”
said Will Vizuete, PhD, assistant professor of
environmental sciences and engineering, who
worked on the UAE outdoor air quality team.
With the model’s design, scientists at the
public health school have created the infra-structure
to track pollutants plaguing the
UAE, a critical step for making policy deci-sions
to reduce emissions.
Researchers now are drafting recommen-dations
on how to improve the country’s
ambient air-monitoring stations and design-ing
a study to measure more precisely the
pollutants in the air.
Epidemiology study
The UAE-UNC Indoor Air, Health and
Nutrition study is evaluating the air Emiratis
breathe inside their homes, the food they eat
and their general health and lifestyle pat-terns.
The assessment will be done in 600
homes across the seven emirates.
The UNC team of 20 faculty and staff
members are coordinating the study and
working with faculty members from the
United Arab Emirates University, who have
hired more than 50 field interviewers to visit
study participants’ homes.
On their first home visits, field interview-ers
set up air monitors and make a list of
the home’s residents. Interviewers return
seven days later to remove monitors and
interview participants about their health his-tories,
diets and lifestyles
(e.g., whether they smoke
or have recently exercised).
Field interviewers record
interview responses into
a computer program that
has been translated into
Arabic. Our public health
school’s Collaborative
Studies Coordinating Cen-ter
(CSCC) developed the
program and will analyze responses, says C.
Edward Davis, PhD, research professor in the
Department of Biostatistics.
The air monitors measure seven pollutants,
including nitrogen dioxide, carbon monoxide,
sulfur dioxide and particulate matter. Par-ticulate
matter is of special concern because
increased exposure to fine and coarse particles
is related to increased cardiovascular and respi-ratory
disease exacerbations and outcomes.
To monitor for these particles, research-ers
use an innovative device called a UNC
passive aerosol sampler. The instrument was
developed by UNC alumnus Jeff Wagner,
PhD, when he was a graduate student in
environmental sciences and engineering,
and David Leith, ScD, professor and associate
chair of the department.
The goal of the study is to provide useful
information about potential health effects
of indoor air pollutants and determine the
general health and nutrition status of Emi-ratis,
said Karin Yeatts, PhD, the study’s
co-principal investigator and research assis-tant
professor of epidemiology. The project
principal investigator is Andy Olshan, PhD,
chair of the department.
“I hope that the study findings will help
the Environment Agency-Abu Dhabi with
their air quality regulations,” Yeatts said,
“either to strengthen the regulations or verify
that what they currently have is useful for
protecting the public’s health.” n
–Natalie Gott
Researchers evaluated everything from water quality,
to food safety, to global climate change. They
found that outdoor air pollution is the top
environmental threat to the country, followed by
indoor air pollution and occupational exposures.
Playing outdoors usually is
a healthy activity, but out-door
air quality in the UAE
threatens the country’s 4.8
million people, especially
children and the elderly.
Dr. Will Vizuete Dr. Karin Yeatts
Ti ina Fol ley
16 | SPRING 2 0 1 0
f e at u r e s a n d n ews
A community health worker
in rural Arizona provides sup-port
and education to medically
underserved migrant workers
and new immigrants with dia-betes.
He helps order glucom-eters
and visits the workers if
they are sick.
Peers for Progress, a pro-gram
led by Edwin Fisher, PhD,
professor of health behavior and health
education at UNC Gillings School of Global
Public Health, is working to ensure that more
people living with diabetes or other chronic
health conditions have access to similar peer-support
networks.
Ongoing support from others who are
coping with similar difficulties can offer
emotional, social and practical assistance
that will help people become healthy.
“Unless they are very sick, people with
diabetes probably spend fewer than six
hours each year in a health professional’s
office,” Fisher says. “That leaves 8,760 hours
each year they are ‘on their own.’
Peer support can help people take
the plans they make in the doctor’s
office and put them into practice in
their daily lives. They get their ques-tions
answered and stay motivated to
sustain healthy patterns across those
8,760 hours.”
The American Academy of Family
Physicians Foundation established
Peers for Progress in 2006. Recognizing
UNC’s pre-eminence in community and
peer approaches to health promotion, the
group asked Fisher and colleagues to host
its Program Development Center a year later.
Faculty members, students and research staff
from the public health school’s health behav-ior
and health education department and
UNC’s School of Medicine guide the Center.
With initial funding from Eli Lilly and
Company Foundation, Peers for Progress has
focused on the global diabetes epidemic, pro-jected
to grow to 439 million people by 2030.
To accelerate best practices for peer support
around the world, Peers for Progress aims
to expand the proof that such programs are
beneficial. It collects information about the
many available programs, so as to secure rec-ognition
and resources for peer support as a
core component of prevention and health care.
“The niche of Peers for Progress is to net-work
with organizations around the world
to facilitate more programs, better-quality
programs and more secure support so the
programs can help as many people as pos-sible,”
Fisher said.
UNC Gillings School of Global Public
Health has a long tradition of providing
peer support in local communities. Current
faculty including Eugenia Eng, DrPH, and Jo
Anne Earp, ScD, professor and chair, respec-tively,
in the Department of Health Behavior
and Health Education, and Alice Ammer-man,
DrPH, and Marci Campbell, PhD, pro-fessors
of nutrition, have been involved in a
number of projects that empower individuals
through individual and group peer support. n
–Natalie Gott
Peers for Progress:
A peer educator in Cambodia conducts weekly group
sessions, offering lessons about diabetes manage-ment
and advice about physical activity and nutrition.
Learn more about Peers for Progress
at www.peersforprogress.org.
For information about MoPoTsyo, a non-governmental
peer-support program in
Cambodia, visit www.mopotsyo.org/
peereducation.html.
For information about Campesinos Diabetes
Management Program, a peer-support group
in Arizona, visit www.diabetesinitiative.org/
programs/DICSF.html.
Peers for Progress’ executive board met in February 2009 to honor Dr. Jose Caro (front, center)
who, as an executive at Eli Lilly and Company, conceived of the initial plan for Peers for Progress.
The board includes UNC public health faculty members Drs. Jo Anne Earp, Ed Fisher, Laura
Linnan and Deborah Tate.
Fisher heads global group
providing diabetes support
Tom Fuldner
Dr. Edwin Fisher
c a r o l i n a p u b l i c h e a l t h | 17
Across the United States, municipalities
use UNC-developed techniques to iden-tify,
remove and preclude the formation of
“disinfection byproducts” from drinking
water. These contaminants are created when
chlorine and other chemicals used to purify
drinking water mix with substances in water.
In eastern North Carolina, cities and
towns have water-sharing and other water
resource management agreements, devel-oped
with the assistance of UNC water
experts, which make the most of scarce water
resources and limited public budgets. The
agreements are in effect not only in rural,
“down-east” communities but also in the
Research Triangle area, home to some of the
state’s largest cities.
Since the 1920s, when H.G. Baity began
teaching sanitary engineering at the Uni-versity
of North Carolina, UNC has been a
leader where water and health intersect. From
locating the purest sources to developing tech-nologies
that keep drinking water safe, UNC
faculty members and students are innovators.
Into this powerhouse now comes Jamie
Bartram, PhD. For more than 30 years,
Bartram has analyzed and advanced connec-tions
between the environment and health
around the world. He comes to UNC from
the World Health Organization, where he
was coordinator for assessing and managing
environmental risks to health.
In July 2009, he joined the environmental
sciences and engineering faculty at the UNC
Gillings School of Global Public Health,
where his mission, through the establishment
of a new Water Institute at UNC, is to bring
together the many streams of water exper-tise
within the School and university and
incorporate them into one powerful river of
research, teaching and service with partners
throughout the state, nation and world.
“This School has an amazing track record
of success at the junction between public
health and water and sanitation,” Bartram
said. “We’re at a point now where draw-ing
together and focusing our strengths
with those of our partners will enable us to
make an even greater impact. The complex
problems of today and tomorrow demand
interdisciplinary responses. Our vision is to
break the boundaries that constrain prob-lem-
solving by bringing together disciplines
and sectors to confront some of humankind's
most critical challenges, whether at the local,
national or global level.”
Philip Singer, PhD, UNC’s Dan Okun
Distinguished Professor of Environmen-tal
Engineering, has contributed greatly to
the strength of UNC’s reputation in water
research. In 2006, he received the National
Water Research Institute’s acclaimed Clarke
Prize for excellence.
“UNC has a world-class reputation in
water resources, drinking water research
and sanitation,” Singer said. “We have a lot of
students and faculty doing work on a variety
of subjects involving drinking water and
public health, but it’s not a cohesive effort.
If we can bring everybody together under
a single umbrella, we’ll be more effective in
our efforts, generating more research fund-ing
and providing more valuable outreach.”
Bartram, Singer said, is the right person to
coordinate and focus such efforts.
“Jamie is an exceptional individual,” Singer
said. “He’s known by almost everybody in the
world in the water and sanitation field. He’s
creative, he’s thoughtful, he’s a visionary. And
at the same time, he’s very down-to-earth and
likeable. I’m excited about what the future
holds for our School and our University.” n
–Ramona DuBose
Water power—
bringing streams together to make a mighty river
In Cambodia, UNC students and faculty
members show people who’ve never had clean
water how to use ceramic filters in their homes.
The lifesaving potential is immense and immediate.
“The complex
problems of
today and
tomorrow demand
interdisciplinary
responses,” says
Dr. Jamie Bartram.
Universit y of Surrey
18 | SPRING 2 0 1 0
Thanks to innovations such as social network-ing,
micro-blogs and instantaneously loaded
video, we can know about an event within
moments of its happening, even if it happens
on the other side of the world.
These dramatic advances in technology—
and our increasingly easy and economical
access to it—affect the ways we learn. For
educators trying to stay one step ahead of
GoogleTM, the challenges may seem to equal
the potential. However, there is no longer a
question of whether technology is essential
to a teacher’s toolkit. It is.
Innovative programs based in UNC Gillings
School of Global Public Health’s Department of
Health Policy and Management and its Public
Health Leadership Program are on the front
lines of educating 21st-century learners.
“The rise of new technologies
poses both profound challenges
and opportunities for educators,”
says William Zelman, PhD, pro-fessor
of health policy and man-agement.
“The teaching-learning
hierarchy is quickly changing
from an emphasis on teaching
to an emphasis on learning—and
how to incorporate technology
into the process.”
“Millennial” students—those
born between 1977 and 1995—
are the focus of Zelman’s new
Gillings Innovation Laboratory.
His “Teaching and Training in
Public Health for the 21st Cen-tury:
Toward a Global Seamless
Classroom” examines issues related to cur-ricula
and engaging students in learning
activities.
“Many millennials are multi-taskers,” Zel-man
says. “They use the Internet for a variety
of tasks, including for texting, e-mailing and
participating in social media, many times
a day. They demand activities that engage
them, and incorporating information tech-nologies
is now an important part of cur-ricular
design.”
Along with others, Zelman has developed
a budgeting module designed to increase the
financial literacy of budding public health
practitioners.
The need for accessible and high-quality
public health education has increased expo-nentially
with the global increase in public
health priorities.
“Current distance learning practices
don’t address the needs of public health
practitioners around the world,” says Rohit
Ramaswamy, PhD, Gillings Visiting Associ-ate
Professor in the Public Health Leadership
Program. “Many of the working public health
professionals in developing countries have
not had access to technology or information
about best practices.”
Ramaswamy’s pilot program, “Leveraging
Local Knowledge to Improve Public Health,”
New methods and technologies transform the teacher’s role in global education
The ways we access and use information have
changed radically over the last decade.
Dr. Rohit Ramaswamy (left) meets with research assistant
Kate Barker, MPH, and Dr. Hollie Pavlica.
How the world learns
l inda kastleman
f e at u r e s a n d n ews
l inda kastleman
c a r o l i n a p u b l i c h e a l t h | 19
is based on a series of collaborations. To
develop the distance learning course for
global public health competencies, he has
worked with School faculty members Wil-liam
Sollecito, DrPH, Diane Calleson, PhD,
and Louise Winstanly, LLB, MS, of the Public
Health Leadership Program, who teach, and
Eugenia Eng, DrPH, Allan Steckler, DrPH,
and Laura Linnan, PhD, of the Department
of Health Behavior and Health Education,
who designed the curriculum.
Public health professionals in six learn-ing
units—three in Ethiopia and one each
in India, South Sudan and Swaziland—have
taken part in the pilot program. The units
include people who work together routinely
and face similar public health challenges.
“Our School has developed expertise in
educating degree-program students in col-laboration
and knowledge sharing,” Ramas-wamy
says. “Although program participation
does not result in an academic certificate
or degree, the practice of public health is
improved globally through participants’
common understanding of best practices.”
Another distance-learning endeavor, the
Public Health Leadership Program’s new
online Certificate in Global
Health, offers formal academic
certification. Developed in part-nership
with the School’s Office
of Global Health with Fogarty
International Center American
Recovery and Reinvestment Act
(ARRA) funds and a grant from
the UNC General Administra-tion,
the certificate program
includes courses in critical global
health issues, ethics, infectious
disease epidemiology, and moni-toring
and evaluation.
Like the innovative programs mentioned
above, this new certificate program uses
a collaborative learning approach so that
global leaders and health practitioners can
share knowledge with fellow program par-ticipants.
As students live around the world,
their experiences also will enrich the course.
“The Public Health Leadership Program has
a long history of success in online leadership
education,” says Hollie Pavlica, DrPH, clinical
assistant professor in the program, “and we
are uniquely positioned to meet the challenges
faced by health leaders around the world.”
James Porto, PhD, clinical assistant pro-fessor
and director of executive programs in
health policy and management, teaches a class
that tracks health care reform
legislation. Students’ research,
observations, questions and
interactive Tweets are collected
on a blog site, http://hpm755unc.
wordpress.com, which serves as
a news aggregator for the class.
“Ninety-five percent of man-agement
is decision making
and problem solving,” Porto
says. “This format (which
involves students analyzing
health care proposals and hav-ing
their analyses critiqued)
lends itself well to public health
issues students will face in the
real world.”
“It’s essential,” Porto says,
“to be able to organize infor-mation.
I see my role as that of
a navigator through the many
available resources.”
The Executive Doctoral Program in Health
Leadership, based in the Department of Health
Policy and Management, prepares mid-career
professionals for senior-level positions in orga-nizations
working around the world to improve
the public's health. The three-year, cohort-based
distance program confers a Doctor of
Public Health in health administration.
Students interact with faculty members
and peers primarily online, using technol-ogy
that supports live video, audio and data
sharing.
One of the pinnacles of the School’s online
global health efforts occurred in the execu-tive
leadership program on Jan. 21, 2010. The
first international online dissertation pro-posal
was defended successfully. It involved
a student from Lebanon, faculty members
from American University and St. Joseph’s
University in Beirut, a faculty member in
Paris, and two faculty members in Chapel
Hill (Edward “Ned” Brooks, DrPH, and John
Paul, PhD, clinical associate professors of
health policy and management).
The world moves fast, but it’s getting
smaller every day. n
–Linda Kastleman
• Read more about Zelman’s Gillings Innovation Lab
at www.sph.unc.edu/accelerate/gils/zelman.
• Read more about Ramaswamy’s Global Learning
Program at www.sph.unc.edu/glp.
• Read more about the School’s Certificate in Global
Health at www.sph.unc.edu/phlp/globalhealth.
Applications for fall 2010 will be accepted until
June 1.
• Read more about the online executive doctoral
program in health leadership on the School’s Web
site (www.sph.unc.edu/drph) and in the Spring
2006 issue of Carolina Public Health magazine
(www.sph.unc.edu/cph/drph).
(Left) Alumni Julie Golding and Ju-Yeon
Park multi-tasked between classes last
spring in the atrium.
Dr. James Porto Dr. William Zelman
0
1
2
3
4
5
6
7
8
9
Blogging or
on Twitter
0.6
8.5
0.6
2.3
In a virtual
community
Text
messaging
Instant
messaging
On social
networking
sites
E-mails
3.9
3.4
Working millennials in the U.S. report
how many hours per week they spend
using various technologies
This graph is based on statistics reported
in 2010 by Accenture, a global consulting
and technology firm. The full report is at
http://snipurl.com/accenture-millennials.
20 | SPRING 2 0 1 0
Orange
Zambezi
Volta
Niger
Benue
Lake
Tanganyika
AFRICA
REP. OF
THE
CONGO
LIBERIA
ANGOLA
NAMIBIA
ZIMBABWE
D'IVOIRE
CÔTE
EQUATORIAL GUINEA
GHANA
MALAWI
BURUNDI
UGANDA
CAMEROON
GABON
REPUBLIC
CENTRAL AFRICAN
TANZANIA
ANGOLA
ZAMBIA
LESOTHO
BOTSWANA
SOUTH
TOGO
N A M I B D E S E R T
D E S E R T
K A L A H A R I
Congo
DEMOCRATIC
REPUBLIC
OF THE CONGO
C O N G O
B A S I N
Kinshasa
RWANDA
“As the late Senator Daniel Patrick Moyni-han
once said, ‘You can’t solve a problem
until you first learn how to measure it,’” says
Meshnick, who leads a highly collaborative
Gillings Innovation Laboratory project to
quantify cases of HIV and tropical disease in
the Democratic Republic of the Congo (DRC).
Infectious diseases are the leading cause of
death and disability in developing countries
such as DRC. Yet remarkably, international
health and development organizations don’t
have good figures on how many people suffer
from these diseases.
“There aren’t reliable estimates or maps
of where people are,” says Meshnick, an epi-demiology
professor at UNC Gillings School
of Global Public Health. “This is a burning
public health problem.”
And he’s about to help extinguish it, first
for the DRC and then for other countries
that undertake similar projects. In April
2010, Meshnick planned to share his team’s
results with the DRC’s Ministry of Health,
after which the team was to write formal
reports of their findings. Such information
will allow aid groups to make better decisions
about where to expend money and resources.
Meshnick’s interdisciplinary team has
spent more than a year analyzing dried
blood-spot samples for prevalence of disease.
The team includes epidemiologists, geog-raphers,
molecular biologists and tropical
disease experts.
Under the guidance of three doctorate-level
Congolese researchers, two labs in
Kinshasa, DRC, are extracting serum from
samples to gauge levels of African sleeping
sickness. At UNC-Chapel Hill, the lab is
measuring HIV and malaria.
Researchers at UNC include epidemiol-ogy
postdoctoral fellow Steve Taylor, PhD,
microbiology doctoral candidate Martha
Clark, geography doctoral candidate Jane
Messina, assistant professor of microbiology
Julie Nelson, PhD, and associate professor of
geography Mike Emch, PhD.
The team records where people who have
the diseases are located. A high prevalence
of HIV was found in the war-torn eastern
areas, for instance. There also is a high
prevalence of malaria not only in rural areas,
as expected, but in densely populated areas
around Kinshasa.
Tracking
tropical disease
You may not hear an epidemiologist quote
a politician very often, but Steven R.
Meshnick, MD, PhD, has been known to.
Dr. Steven Meshnick (right) works
with Kashamuka Mwandagalirwa
(left) and Jeremie Muwonga to sort
dried blood-spot samples.
f e at u r e s a n d n ews
kathryn johnson
c a r o l i n a p u b l i c h e a l t h | 21
Tanganyika
Lake
Nyasa
Victoria
Lake
MALAWI
BURUNDI
UGANDA
ETHIOPIA
KENYA
TANZANIA
MOZAMBIQUE
Mt. Kilimanjaro
(highest point in
A ica, 5895 m)
G R E A T R I F T V A L RWANDA
But don’t think there’s funny business inside.
The unlikely laboratory is the place where
Mike Aitken, PhD, chair of UNC’s Depart-ment
of Environmental Sciences and Engi-neering,
is conducting research to stem water
and air pollution that comes from treated hog
waste, a big issue in North Carolina, the sec-ond
largest pork-producing state behind Iowa.
Through a Gillings Innovation Lab, Ait-ken
and his team purchased the trailer sec-ond-
hand. The ESE Design Center equipped
it to operate as an onsite laboratory. Now
parked by a hog-waste lagoon at Butler’s farm
near Lillington, the lab is testing Aitken’s
idea for removing ammonia, a noxious form
of nitrogen, from the waste.
Ammonia is a desirable fertilizer, but
too much of it damages soil and denigrates
groundwater. “There is more nitrogen pro-duced
from hog waste in eastern North
Carolina than could ever be used for crops
in that region,” Aitken says.
Furthermore, when farmers spray ammo-nia-
rich waste on crops as fertilizer—a common
practice­—
much of the ammonia is released to
the atmosphere, generating the smelly odor
If you visit Tom Butler’s hog farm in Harnett
County, N.C., you might spot a covered trailer
bearing the faint logo of a rodeo clown.
Converting hog waste
into energy
“We are currently looking into whether
HIV or drug-resistant malaria tends to asso-ciate
with refugee camps,” Meshnick says.
The team also looks at its data in light
of information from the Demographic and
Health Survey conducted in the DRC in
2007, which featured interviews with nearly
9,000 households. Surveyors also obtained
dried blood-spot tests to check for HIV, and
that’s where Meshnick’s team got its samples.
“We got the leftovers,” he says.
But the “leftovers” were enough for a
project that Meshnick believes will evolve
into something more extensive over the next
decade. Gene chips now being developed will
allow robots to analyze far more about DNA
than current methods can. These chips can
look at thousands of antibodies and patho-gens
from a dried blood spot.
“Ultimately, we could look for any disease
you can imagine,” Meshnick says. n
–Susan Shackelford
Dr. Steven Meshnick
Malaria Prevalence
DRC 2007
High: 94%
Low: 2% 8
Dr. Mike Aitken
janey messina/carol ina population center
f e at u r e s a n d n ews
22 | SPRING 2 0 1 0
for which hog waste is well known.
Ammonia also reacts in the atmosphere
to form fine particles that cause respiratory
problems such as asthma.
“This is a big public health problem,”
Aitken says, going on to describe the process.
“We are converting ammonia to nitrate, and
then nitrate to nitrogen gas, which represents
79 percent of our atmosphere and can be
harmlessly released.”
The process consists of conventional waste-water-
treatment technology, but two aspects
of the project are unusual, Aitken says.
It’s coupled with another project at the site
which captures methane from the treated hog
waste to generate electricity and thus mini-mize
the release of the potent greenhouse gas.
Under a pilot program the state began
in 2007, investor-owned utilities in North
Carolina are required to buy the electricity.
The farmer receives up to 18 cents per kilo-watt
hour, Aitken says. That far exceeds the
several cents per kilowatt hour that utilities
typically pay other power producers and thus
could significantly help offset the farmer’s
technology cost.
The other innovative part of Aitken’s
project is technical. At a nominal cost, InVen-tures
Technologies Inc. is providing a “bub-ble-
less” aeration system that supplies oxygen
required to convert the ammonia to nitrate.
This method is superior to traditional tank-and-
bubble systems for two reasons, Aitken
says. It minimizes the release of ammonia
from the treatment system and also may
minimize emission of the greenhouse gas
nitrous oxide, a by-product of the process.
Aitken began testing the ammonia-removal
system in the first quarter of 2009
and expects the demonstration to last a
year. Assisting him are graduate students
Sarah Bunk and Eric Staunton, as well as
Joe Rudek, PhD, a hog-waste policy expert
with the Environmental Defense Fund in
Raleigh, N.C., who holds master’s and doc-toral
degrees from the UNC department
Aitken heads.
While there are state incentives for the
energy-conversion process, both Aitken and
Rudek hope additional incentives, including
credits for carbon and nitrogen removal, will
emerge as legislation.
So far, Aitken says, “The state is not con-necting
the dots.”
He hopes to make the connections clear
soon. But for now, he says with a chuckle,
“The trailer is turned so that you can’t see
the clown logo from the road.” n
–Susan Shackelford
Field technician John McNeill (left) and Dr.
Glenn Walters, director of the ESE Design
Center, discuss design strategies for main-taining
pressure in a tank used to remove
nitrogen from hog waste. At right, plastic
covering over a hog waste lagoon not only
contains the noxious smell of ammonia but
also captures methane, which will be used
to generate electricity instead of being
released as a greenhouse gas.
Dr. Mike Aitken
l inda kastleman
tom fuldner
Dr. Mike Aitken
c a r o l i n a p u b l i c h e a l t h | 23
The naturally occurring compound is the
most harmful human carcinogen, says Miro-slav
Stýblo, PhD, associate professor of nutri-tion
at UNC Gillings School of Global Public
Health. It affects between 60 million and
100 million people around the world, most
of whom are exposed by drinking water that
has passed through geological formations
containing arsenic.
“We have good evidence that links chronic
arsenic exposure to cancers of the skin,
bladder, lungs and possibly the liver,” Stýblo
explains. “It can also cause a spectrum of
other diseases—cardiovascular disease, dia-betes
and probably many others.”
Stýblo’s Gillings Innovation Lab has taken
a two-pronged approach to the problem. One
objective is to develop techniques sensitive
enough to detect arsenic in very small tissue
samples.
The other goal is to analyze how arsenic is
metabolized in human tissues into compounds
more toxic than those found in drinking water.
The basic method for detecting arsenic in
human tissue was developed some time ago.
But researchers struggle with several chal-lenges,
primarily that the most toxic forms
of arsenic disintegrate when exposed to air.
Consequently, handling samples has been a
stumbling block. The problem is compounded
because areas where arsenic exposure is most
widespread—primarily Southeast Asia, Ban-gladesh
and the West Bengal region of India—
tend to be rural and less developed.
In 2009, Stýblo’s team designed a cus-tomized
lab at UNC that integrates and
modifies the work of two researchers in
Prague, Jiří Dědina and Tomáš Matoušek of
the Institute of Analytical Chemistry of the
Academy of Sciences of the Czech Republic.
Together, they have developed an inno-vative
and inexpensive
approach that uses very
small samples. While
fine-tuning the tech-nique,
they are sharing
it with three laboratories
in Mexico, another country where arsenic
causes widespread harm.
Now Stýblo’s lab is tackling its second chal-lenge,
analyzing the toxic compounds created
when the human body metabolizes arsenic.
Researchers previously have analyzed urine
samples to determine arsenic exposure, but
such samples can’t tell us what arsenic does
when it remains in human tissue.
Stýblo and his team are developing new
ways to discern arsenic’s impact on the lungs
and bladder. Andrew J. Ghio, MD, medical
officer in the U.S. Environmental Protection
Agency’s Human Studies Division, leads a
UNC-based study that provides Stýblo’s lab
with epithelial cells from the airways of smok-ers
exposed to arsenic in cigarette smoke. Two
researchers in Mexico, Luz María Del Razo of
the Research and Advanced Studies Center of
the National Polytechnic Institute of Mexico
(Cinvestav–IPN) and Gonzalo García Vargas
of Universidad Juarez del Estado de Durango,
supply exfoliated bladder cells isolated from
the urine of Mexican residents exposed to
arsenic in drinking water.
Stýblo’s innovative analytical methods
will give epidemiologists cheaper and better
ways to identify and understand how arsenic
harms human beings. The goal, he says, is to
transfer this methodology to the field. That
will give those working to stop a killer a new
weapon to use. n
–Kathleen Kearns
Unraveling the mystery
of arsenic’s modi operandi
Murder mysteries have given arsenic a sinister
reputation, but the damage it does is no fiction.
Stýblo is developing new ways to discern how arsenic
impacts the human lungs and bladder.
Dr. Stýblo (center) poses
with Dr. Luz María Del
Razo (second from left),
UNC’s Dr. Zuzana Drobna
(in orange), Mayor
Eusebio Aguilar and local
public health workers in
Zimapan, Mexico.
Dr. Miroslav Stýblo
dr gonzalo garcia-vargas
24 | SPRING 2 0 1 0
So where do you find a “safe” job for teen-age
workers? A clothing store at the mall?
A fast-food restaurant? About 77 percent of
teens who work have jobs in retail and service
industries, according
to the Bureau of Labor
Statistics. Those jobs
might seem safer than
jobs in construction
or agriculture.
But Carol Runyan,
PhD, director of the
UNC Injury Preven-tion
Research Center
and professor of health behavior and health
education at the UNC Gillings School of
Global Public Health, wants young workers
and their families to know that injuries occur
on all kinds of job sites. More than 200,000
teenagers are injured on the job each year.
“Food slicers, hot grease, slippery floors
and box crushers account for some of these
injuries,” Runyan says. “Restaurants, food
stores and the fast-food industry can be haz-ardous
places for young workers.”
Fifteen years ago, Runyan and her team
collected statistics on young worker fatali-ties
in North Carolina. She wanted to help
prevent these deaths, so she began analyzing
the circumstances in which teens work.
The national study she led, interviewing
about 900 youth workers in retail and service
occupations, showed that one-third of the
respondents did not receive safety training
and many worked without supervision. Her
survey of teenagers working in construction in
N.C. found that 84 percent of those surveyed
performed tasks prohibited by child labor laws.
“My research leads to where interventions
need to be,” Runyan says.
She identified interventions including
enforcement of and education about child
labor laws and development of strategies
to ensure worker safety, such as employers’
learning how best to supervise teenagers.
“Young workers lack experience,” says
Runyan. “In an attempt to demonstrate com-petence,
they may take risks, not understand-ing
the hazards involved. The responsibility
for safety lies with the employer—and with
the government, to set regulations, monitor
compliance and then hold employers’ feet
to the fire.”
Runyan’s work has been groundbreaking
in its impact on young workers’ safety. In
2009, after significant media coverage of
her studies, she was urged by N.C. Rep. Jen-nifer
Weiss and the N.C. Child Fatality Task
Force to share her results with several legis-lative
committees, leading to two new laws
designed to protect working children. One,
a law with tougher penalties for employer
violations, went into effect in North Caro-lina
in December 2009. The other requires
the N.C. labor commissioner to provide
detailed reports on child labor complaints
and obstacles to child labor law enforcement.
“This is an important step in raising
awareness of young worker safety and the
need to ensure that employers are account-able,”
Runyan says. n
–Chris Perry
Safety first on the job,
especially for inexperienced teens
Wanted: Secure job for teenage worker.
Prefer no big equipment, no tractors or
trucks, no heavy lifting. Safety is a top priority.
Agriculture/forestry/ Construction
fishing/hunting
Transportation/warehousing
Manufacturing
Retail trade
N=6,290
Information
Education/health
services
Other
Leisure/hospitality
Data provided by Janice Windau of the U.S. Bureau of Labor Statistics, from the Bureau's Survey of Occupational Injuries
and Illnesses. Reprinted with permission from the Web site of the U.S. Centers for Disease Control and Prevention's
National Institute for Occupational Safety and Health (http://snipurl.com/cdc-young-worker-injury).
The majority of young
people injured on the job
work in the service and retail
industries. (Shown here are
U.S. data for 2007.)
Dr. Carol Runyan
“Restaurants, food stores and the fast-food
industry can be hazardous places for
young workers,” says Dr. Carol Runyan.
l inda kastleman
f e at u r e s a n d n ews
But a decade of work by North Carolina
public health and dental researchers at UNC
has resulted in a kind of magic of its own­—
innovative programs that really do brighten
the smiles of the state’s youngest and most
vulnerable.
One of the prevention programs is work-ing
so well that 35 other states have adopted
North Carolina’s model.
Into the Mouths of Babes was established
in 2000 by a collaborative of public and
private medical and dental groups, with
funding from N.C. Medicaid. The initiative
trained physicians to paint fluoride varnish
on infants’ and young children’s teeth, screen
for tooth decay and provide dietary and other
dental health information to their parents.
The program already reaches Medicaid-covered
children in North Carolina in 45
percent of their well-child visits, says Gary
Rozier, DDS, MPH, professor of health policy
and management at the UNC Gillings School
of Global Public Health.
Rozier and others founded the program
after seeing an increase in dental disease
in young children, particularly those from
low-income families and those with poor
access to dental care. The program marked
the first time physicians started “‘working
in the mouth,’ if you will,” said Rozier, who
holds a Doctor of Dental Surgery from UNC-Chapel
Hill.
In conjunction with Into the Mouths of
Babes, Rozier helped develop two more proj-ects
to serve the dental
needs of young North
Carolinians.
Carolina Dental
Home is a pilot program
in Craven, Jones and
Pamlico counties that
works to ensure access to pediatric dental
services despite a shortage of dentists. Using
an assessment tool developed by UNC and the
N.C. Division of Public Health’s Oral Health
Section, physicians evaluate a child’s teeth and
risk factors and decide whether to continue
treating the child or refer him or her to a gen-eral
or pediatric dentist trained through the
program to work with young children. Physi-cians,
for instance, will advise parents about
health behaviors, such as the use of fluoridated
toothpaste, but will refer a child with a cavity
to a participating dentist. Officials have seen
increased referral rates and improved efficiency
since the program started, Rozier said.
“All of these efforts are focused on increas-ing
access to preventive services at an early age
so we can get to these kids before disease occurs
and prevent poor outcomes like hospitalization,
which is much too frequent,” Rozier said.
“The many collaborations between Dr.
Rozier and the Oral Health Section of the
N.C. Division of Public Health are a model
for the state,” said Rebecca King, DDS, MPH,
chief of the Oral Health Section. “Working
together, the public health school and the state
health department bring together the best of
the worlds of research and public health prac-tice—
to the benefit of North Carolinians.”
The other new project aims to promote
preventive dental care in Early Head Start
programs. Children who attend a participat-ing
Early Head Start program have their teeth
brushed with fluoridated toothpaste at least
once every day in the classroom. Teachers
learn about oral health care and relay the
information to parents and caregivers. Seven-teen
programs participate in the Early Head
Start initiative in North Carolina, Rozier said.
Combined, the three programs provide a
long list of benefits for preschool-aged children
and their families. They help prevent tooth
decay, reduce the amount of treatment a child
needs and generally improve the oral-health-related
quality of life for families, Rozier said. n
–Natalie Gott
All of these efforts are focused on increasing
access to preventive services at an early age.
Dr. Gary Rozier (center)
discusses his work in
North Carolina with
(l-r) project manager
Leslie Zeldin; Dr. William
Vann Jr., professor of
dentistry; postdoctoral
fellow Dr. Bhavna Pahel;
and Dr. Daniel Lee.
Putting new ideas where
their mouths are
Face it­—
no tooth fairy is going to swoop in and
mend the mouths of children with poor oral health.
c a r o l i n a p u b l i c h e a l t h | 25
l inda kastleman
26 | SPRING 2 0 1 0
Both local and national media
have sought out School faculty members to
comment on aspects of the national debate
on health care reform, particularly after a
bill was passed in March. Among those most
often quoted are Tim Carey, MD, director
of the Cecil G. Sheps Center for Health Ser-vices
Research and adjunct epidemiology
faculty member; Dean Harris, JD, clinical
associate professor of health policy and
management; Jon Oberlander, PhD, profes-sor
of health policy and management and
social medicine; and Thomas Ricketts, PhD,
professor of health policy and management.
Media included The New England Journal
of Medicine, The New York Times, National
Public Radio, USA Today, MSNBC, CBS Sun-day
Morning and Evening News programs,
American Public Radio’s Marketplace, AARP
Bulletin Today, The Daily Tar Heel (UNC),
WCHL Radio and The News & Observer
(Raleigh, N.C.).
Health policy and management doctoral
student Brad Wright also blogs about health
care reform in The Huffington Post (see www.
huffingtonpost.com/d-brad-wright). n
In fiscal year 2009, despite a major
economic recession, more than 400 grants
and contracts, totaling more than $150 mil-lion,
were awarded to faculty members with
a primary appointment in the School—a 45
percent increase from the previous year.
Among the highlights:
Gates Foundation grant for
urban reproductive health
The Bill & Melinda Gates Founda-tion
awarded more than $22 million for a new
project to improve reproductive health of the
urban poor in sub-Saharan Africa and South
Asia. Ilene Speizer, PhD, research associate
professor of maternal and child health, is one
of the two leaders of “Measurement, Learn-ing
and Evaluation for the Urban Reproduc-tive
Health Initiative,” which will be run by
UNC's Carolina Population Center. Working
with the center on the project are the African
Population and Health Research Center, based
in Nairobi, Kenya, and the Population Refer-ence
Bureau in Washington, D.C. The project
will help identify which urban reproductive
health approaches and interventions are most
effective and likely to have the biggest impact.
Statistical Methods for
Cancer Clinical Trials
Michael R. Kosorok, PhD, professor
and chair of the biostatistics department, will
lead researchers from UNC, Duke University
and N. C. State University to find ways to
design more powerful clinical trials for cancer
treatments. Their aim is to more quickly and
effectively deliver better, more personalized
new therapies to cancer patients. “Statistical
Methods for Cancer Clinical Trials,” a $12.5
million, 5-year grant from the National Cancer
Institute, is designed to develop new methods
for the design and analysis of cancer clini-cal
trials. Co-investigators from the School
include Joseph Ibrahim, PhD, Alumni Dis-tinguished
Professor of biostatistics; Jianwen
Cai, PhD, biostatistics professor and associate
chair; and Danyu Lin, PhD, Dennis Gillings
Distinguished Professor of biostatistics.
Center of Excellence
in Genomic Science
The National Institutes of Health’s
National Human Genome Research Institute
and National Institute of Mental Health have
awarded UNC an $8.6
million, 5-year grant
to establish a Cen-ter
of Excellence in
Genomic Science. The
center will explore
how genes and the
environment inter-act
and affect certain
mental diagnoses,
including autism, depression, anxiety and
adverse reaction to antipsychotic medicines.
Public health researchers include Daniel
Pomp, PhD, nutrition professor; and Fred
Wright, PhD, professor, Fei Zou, PhD, asso-ciate
professor, and Wei Sun, PhD, assistant
professor, all in biostatistics.
Sobsey presents water test idea to
NASA, USAID and others
Mark Sobsey, PhD, Kenan Distin-guished
Professor of environmental sciences
and engineering, is one of 10 innovators
who participated in the first LAUNCH
SCHOOL NEWS
For more information on these topics and other news, please see www.sph.unc.edu/news_events.
unc gil l ings school of globa l publ ic hea lth
Explaining the health
care reform debate
Major grants
Dr. Daniel Pomp
Dr. Jon Oberlander Dr. Thomas Ricketts
c a r o l i n a p u b l i c h e a l t h | 27
Social media sites provide an easy, and
now mainstream, means to share informa-tion
about research, practice and education
opportunities—and a great way to network
with colleagues, classmates and others.
UNC Gillings School of Global Public
Health offers a variety of ways for students,
alumni and friends to stay connected with
the School and each other around the world.
Check out these opportunities:
Tap into relationships and stay informed.
www.linkedin.com
Post or search for jobs in public health.
www.uncsph.experience.com
Find alumni in our online community.
www.alumniconnections.com/sph.unc.edu
Follow the School on Twitter.
www.twitter.com/uncpublichealth
Check out the School’s YouTube channel.
www.youtube.com/user/UNCpublichealth
Picture what the School has been up to.
www.flickr.com/photos/uncsph/collections
Join our Facebook community.
www.facebook.com
For links to more
School connections
(Dean’s blog, events
calendar, RSS feeds,
iTunes podcasts,
myspace, Second Life,
Wikipedia, Student
Affairs blog), visit
www.sph.unc.edu/
more_connections.
event, held March 16–18, 2010, at Kennedy
Space Center in Florida. LAUNCH spon-sors
include NASA, the U.S. Agency for
International Devel-opment
and the U.S.
State Department.
The inaugural event
focused on water sup-ply
and quality.
Sobsey presented a
proposal for simple,
accessible, afford-able
tests to assess
water quality and safety to the 30-member
LAUNCH Council, a diverse group of entre-preneurs,
scientists, engineers and others
who advised presenters about how to move
their innovations forward into commercial
production, field deployment and use.
Sobsey received a Gillings Innovation
Laboratory to develop portable field tests to
detect fecal contamination in water. He and
an international team are designing reli-able
fecal microbe tests that will not require
sophisticated laboratory equipment, electric-ity
or advanced training of test users. n
Technology enhances communication
about the School
Dr. Mark Sobsey
Events and other news
Minority Health Conference
addresses health inequality
in the modern world
The 31st annual Minority Health Con-ference,
“Building Community in the Age of
Information: Fighting Health Inequality in
the Modern World,” was held Feb. 26, 2010,
at the William and Ida Friday Center for
Continuing Education in Chapel Hill, N.C.
The event was planned and hosted by the
School’s Minority Student Caucus.
Columbia University’s Robert E. Fullilove,
EdD, presented the 12th annual William T.
Small Jr. Keynote Lecture. The conference is
the largest and longest-running student-led
health conference in the country, regularly
attracting more than 500 students, faculty,
researchers, public health and human services
professionals, and community leaders from
N.C. and surrounding states, with at least as
many throughout the country viewing the
keynote lecture by webcast or on DVD.
Online learning certificates
now offered
The School now offers two new online
learning programs for students not seek-ing
degrees. The Public Health Leadership
Program’s online certificate in global health
confers academic certification in global
health competencies, focusing on global
health issues, ethics, epidemiology and
Dr. Robert Fullilove (above) presented the
keynote lecture at the 2010 UNC Minority
Health Conference. Health behavior and
health education students Aprajita Anand
(left) and Emily Brostek led a team of stu-dents
in planning and executing the event. 8
photos by l inda kastleman
28 | SPRING 2 0 1 0
s c h o o l n ews
monitoring evaluation. Apply by June 1,
2010. Learn more at www.sph.unc.edu/phlp/
globalhealth.
The Certificate in Maternal and Child
Health Leadership (MCH Olé!) provides prac-titioners
with core knowledge and skills to
promote the health of women, children and
families around the world. Apply by Oct.
1, 2010. Learn more at www.sph.unc.edu/
mch_online.
New dissertation
awards and merit-based
scholarships offered
Two new programs to support students
have been funded through Carolina Public
Health Solutions, the group administering
the $50 million gift to the School from Den-nis
and Joan Gillings.
As many as two dissertation awards will
be granted to current doctoral candidates
whose work has strong potential for public
health impact. The $5,000 award(s) will be
presented in spring 2010.
Any student applying to a UNC graduate
degree program in public health also will be
eligible to receive merit-based scholarship
support. The School plans to make funding
pools available each year. Academic depart-ments
and the Public Health Leadership
Program will consider applications and make
funding decisions.
Guest lecturers enrich
School experience
Numerous distinguished guests
have made presentations at the School
over the past several months. Below are
Dr. Thomas Frieden
Career fair provides networking opportunities
More than 275 students, alumni
and others attended the School’s
2010 Career and Internship Fair
on Feb. 4, 2010. Thirty-three
companies and agencies sent
representatives to meet some
of the best trained public health
students in the world.
This year, Abt Associates was a
“Gold Sponsor” of the event. Abt
associates apply their expertise
in research, consulting, technical
assistance, data collection, and
medical and life sciences to a
wide variety of problems in the public and private sec-tors.
(See www.abtassociates.com.)
The School thanks Abt and other career fair
sponsors, including ICF International, RTI International
and the School Alumni Association. Read more about
the event at www.sph.unc.edu/career_fair. n
highlights of a few who have shared their
experiences and expertise. To hear many of
these lectures online, visit www.sph.unc.
edu/webcasts.
Dean’s Lecture Series
CDC Director Thomas Frieden, MD,
MPH, spoke on Oct. 9, 2009, about the
ways public health training “bridges the
implementation gap.” More than 400 people
packed the School’s atrium to hear Frieden
discuss Centers for Disease Control and
Prevention and public health priorities,
including improvement of public health sur-veillance
and epidemiology, support of state
and local public health action, strengthening
of global health work and having greater
impact on public health policies.
Dan Ariely, PhD, James B. Duke
Professor of Behavioral Economics at
Duke University and author of Predictably
Irrational: The Hidden Forces That
Shape Our Decisions, presented a talk,
“Predictably Irrational,” on March 26, 2010.
James Marks, MD, MPH, senior vice
president of the Robert Wood Johnson
Foundation, spoke to faculty, staff and
students on April 9, 2010. His talk was
titled “Wayne Gretzky and the Future of
Public Health Leadership.”
2010 Foard Lecture
Jeanne Lambrew,
PhD, director of the
U.S. Department of
Health and Human
Services’ Office of
Health Reform, was
expected at press
time to deliver the
2010 Fred T. Foard Jr.
Memorial Lecture on
April 15 at The Wil-liam
and Ida Friday Center for Continuing
Education in Chapel Hill, N.C. Lambrew
received master’s and doctoral degrees in
health policy (in 1991 and 1993, respec-tively)
from UNC. n
Dr. Jeanne Lambrew
l inda kastleman
Company representative
Brad Hollern and master’s
candidate Alrick Edwards
talk to students about
job opportunities at Abt
Associates.
c a r o l i n a p u b l i c h e a l t h | 29
Harriet Hylton Barr
(1925–2009)
Harriet Hylton Barr, MPH, alumna
and longtime health educator at the School,
died Dec. 14, 2009, in
Durham, N.C. Barr
received a Master of Pub-lic
Health in health edu-cation
from UNC in 1948
and taught health educa-tion
classes at UNC from
1967 to 1994. She served
as the School’s assistant
dean for alumni affairs from 1983 to 1994,
during which time she organized and energized
an alumni association. In 1980, the association
recognized Barr with its Distinguished Service
Award, later renamed in her honor. The Harriet
Hylton Barr Distinguished Alumnus Award
is presented annually to recognize leader-ship,
collaboration and innovation within the
profession of public health; impact within the
practice arena; and outstanding service.
A special remembrance was part of the
School's Foard Memorial Lecture on April
15, 2010.
Memorial donations may be made to the
UNC Gillings School of Global Public Health
Foundation—Harriet Barr Memorial Fund.* n
Barry Margolin
(1943–2009)
Barry Margolin, PhD, former chair of the
School's Department of Biostatistics, died Jan.
28, 2009, after many years
of declining health. Margo-lin
joined the biostatistics
faculty in 1987 as profes-sor
and chair, a position
he held until 1999. He also
served as director of the
biostatistics facility at the
UNC Lineberger Com-prehensive
Cancer Center from 1989 to 1999.
A remembrance ceremony was held at the
School on March 3, 2010. A memorial session
honoring Margolin's distinguished career will
be held at the Joint Statistical Meetings in Van-couver,
Canada, on Aug. 3, 2010. n
Jessie Satia (1971–2010)
Jessie Satia, PhD, associate professor of nutrition
and epidemiology and special assistant to the School's
dean for diversity, died in her home in Chapel Hill, N.C.,
on Feb. 4, 2010, after a long illness.
During her career, Satia published more than 65
papers and authored two book chapters. Her numerous
awards and honors include the Graduate Student Fel-lowship
Award from the University of Washington and
the New Investigator Award from the American Society
of Preventive Oncology in 1999. In 2001, she won the
Dannon Leadership Institute's Nutrition Leadership
Institute Award. She was a three-time recipient, in 1999,
2001 and 2003, of the Minority Research Scholar Award
given by the American Association for Cancer Research.
Satia explored methods and strategies to recruit African-Americans into research studies
for cancer prevention and control. She also assessed and monitored trends in health-related
behaviors among colon and prostate cancer survivors and examined whether health behav-iors
impact cancer prognosis and survival.
Memorial donations may be made to The Dr. Jessie A. Satia Memorial Fund.* n
Mary Rose Tully (1946–2010)
Mary Rose Weber Tully, MPH, alumna and
adjunct associate professor of maternal and child health,
died Jan. 20, 2010, at the N.C. Cancer Hospital in Chapel
Hill, N.C.
Tully was a co-founder and senior clinical associate
of the Carolina Global Breastfeeding Institute in the
Department of Maternal and Child Health. She also
was director of Lactation Services at UNC Hospitals
and a faculty member in the UNC schools of medicine
and nursing.
Memorial donations may be made to The Mary Rose
Tully Training Initiative at the Carolina Global Breast-feeding
Institute.* n
M e m Ionriam
* To make a memorial gift, please visit www.sph.unc.edu/giving, or contact Kembrie Greene Farrow,
Office of External Affairs, UNC Gillings School of Global Public Health, 107 Rosenau Hall, Campus
Box 7400, Chapel Hill, N.C. 27599-7400, telephone (919) 966-0198.
30 | SPRING 2 0 1 0
FACULTY
Devlin joins School as Gillings Visiting
Professor
Leah M. Devlin, DDS,
MPH, former N.C.
State Health Direc-tor,
was appointed
as a Gillings Visiting
Professor in fall 2009.
The position is based
in the Department
of Health Policy and
Management.
In her new role, Devlin is connecting the
School, including the N.C. Institute for Public
Health, with legislators and others working
on public health issues in practice. She also
is consulting with School leaders to develop
approaches to strengthen the school’s capac-ity
as a regional and national leader in public
health quality improvement.
Steckler and Eng recognized as Distin-guished
Fellows, SOPHE’s highest honor
Allan B. Steckler, DrPH, and Eugenia (Geni)
Eng, DrPH, professors of health behavior
and health education, received the Society
for Public Health Education’s Distinguished
Fellow Award for significant and lasting
contributions to SOPHE and to the profes-sion
of health education.
The awards, which are the Society’s high-est
honor, were presented at the organiza-tion’s
annual meeting in Philadelphia in
November 2009.
SOPHE is an independent, international
professional association made up of health
education professionals and students.
Herring elected president of ENAR,
prestigious biostatistics organization
Amy Herring, ScD,
associate professor
of biostatistics, was
elected president of the
Eastern North Ameri-can
Region (ENAR) of
the International Bio-metric
Society (IBS)
for a three-year term,
ending in 2013.
IBS is the largest professional organization
of biostatisticians and biometricians in the
world, drawing its 5,800 members from more
than 25 countries. ENAR is the largest sub-group
of the organization, incorporating 1,600
members from the United States and Canada.
Our School has a strong history of leader-ship
in the society, with four members of
the faculty—including the late Dr. Bernard
Greenberg and Drs. Jim Grizzle, Gary Koch
and Lisa LaVange—having previously served
as president.
Richardson
appointed to White
House advisory board
David B. Richardson,
PhD, associate profes-sor
of epidemiology,
was appointed by
President Obama in
October 2009 to the White House Advisory
Board on Radiation and Worker Health.
Richardson’s research investigates occupa-tional
and environmental causes of disease,
with a particular focus on ionizing radiation.
He has served in various capacities at the
University of North Carolina since 1996 when
he began as a postdoctoral researcher.
Dilworth-Anderson
leads Gerontological
Society, receives
Reagan Award for
Alzheimer’s research
Peggye Dilworth-
Anderson, PhD, pro-fessor
of health policy
and management and
interim co-director of
UNC’s Institute on Aging, was inducted in
November 2009 as the new president of the
awards &
R ecognitionS
unc gil l ings school of globa l publ ic hea lth
August 2009 – March 2010
Details of these and other awards are available at www.sph.unc.edu/school/recognitions.
Dr. Leah Devlin
Dr. Eugenia Eng and Dr. Allan Steckler
Dr. Amy Herring
Dr. David Richardson
Dr. Peggye Dilworth-
Anderson
c a r o l i n a p u b l i c h e a l t h | 31
Gerontological Society of America at GSA’s
62nd annual meeting in Atlanta, Ga.
Dilworth-Anderson is a member of the
National Advisory Council for the National
Institute on Aging and former member
of the board of directors of the National
Alzheimer’s Association.
Dilworth-Anderson also received the
Ronald and Nancy Reagan Research Insti-tute
on Alzheimer’s Disease Award. She
was honored on March 9, 2010, during the
seventh annual National Alzheimer’s Gala in
Washington, D.C.
Baric elected to
American Academy
for Microbiology
Ralph Baric, PhD,
professor of epidemiol-ogy
at UNC Gillings
School of Global Pub-lic
Health, has been
elected to the Ameri-can
Academy for Microbiology. He will be
recognized at the Academy Fellows luncheon
in San Diego in May 2010.
The American Academy of Microbiol-ogy
is the honorific leadership group within
the American Society for Microbiology, the
world’s oldest and largest life science orga-nization.
Baric’s groundbreaking research
focuses on coronaviruses, including SARS,
and on noroviruses.
Read more about his research on page 10.
Adimora selected as one of top 100 African-
American leaders by The Root magazine
Adaora Adimora, MD, MPH, professor of
medicine at the UNC
School of Medicine
and clinical professor
of epidemiology in the
public health school,
was selected by The
Root magazine as one
of the top 100 African-
American leaders.
The Root is a
daily online magazine that aims to provide
thought-provoking news commentary from a
variety of black perspectives. “The Root 100”
is a new honor that highlights the leadership
and service of African-American men and
women whose work impacts their communi-ties
and the world.
Adimora was honored for her research in
HIV/AIDS.
Pink awarded distinguished professorship
in health policy and management
George Pink, PhD,
has been appointed
Humana Distin-guished
Professor of
Health Policy and
Management.
Established
through a grant from
the Humana Founda-tion,
the professorship
is awarded to a health policy and manage-ment
faculty member with a national reputa-tion
for scholarship in health informatics.
Pink is a fellow at the UNC Cecil G. Sheps
Center for Health Services Research and lead
investigator in the center’s N.C. rural health
research and policy analysis center.
Ammerman appointed to state food
advisory council
Alice Ammerman,
DrPH, professor of
nutrition and director
of UNC’s Center for
Health Promotion and
Disease Prevention,
has joined a new state
council focused on
improving policies and
access to local, sustain-able
food in North Carolina.
The North Carolina Sustainable Local
Food Advisory Council was established
by the N.C. General Assembly in August
2009 to study, develop and promote policies
that will create jobs, support communities,
preserve the natural environment, increase
access to fresh and nutritious foods, and
provide greater food security for all North
Carolinians.
Holliday wins award from N.C. Dietetic
Association for contributions to field
Amanda Holliday,
MS, RD, clinical
assistant professor in
the Department of
Nutrition, was named
Outstanding Dietetic
Educator of the Year
by the Durham-Chapel
Hill (N.C.) Dietetic
Association and by
the North Carolina Dietetic Association. She
accepted the statewide award at an awards
event in Princeton, N.J., on March 25, 2010.
STUDENTS
Graduate School announces 24 merit
awards for public health students
Twenty-four UNC public health graduate
students received merit awards for study in
2009–2010 and beyond, the UNC Graduate
School announced in fall 2009.
The students are Sayan Dasgupta (biosta-tistics);
Jonathan Crocker, Katherine Harrold
and Edema Ojomo (environmental sciences
and engineering); Jane Der, Katelyn Haus-man,
Chantel Martin, Melanie Napier, Damon
Ogburn and Amitabh Suthar (epidemiology);
Andrea Des Marais, Ann Gottert, Jessica
Kadis, Elizabeth King and Sarah Lieff (health
behavior and health education); Kristin
Geonnotti, Elise Lockamy and Sarah Rutstein
(health policy and management); Anna Bauer
and Anupama Gomez (maternal and child
health); and Scott Ickes, Erik Karlsson, Tosha
Smith and Rebecca Tkachuk (nutrition).
Health policy and management teams
compete in case competitions
Presha Patel, Gregory Mascavage and Jessica
Folmar, second-year Master of Public Health
students in the health policy and manage-ment
department, won second place in the
14th annual Everett V. Fox Student Case
Dr. Ralph Baric
Dr. Adaora Adimora
Dr. George Pink
Dr. Alice Ammerman
Amanda Holliday
8
f e at u r e s a n d n ews
32 | SPRING 2 0 1 0
Competition, held during the National
Association of Health Services Executives’
annual educational conference in October
2009, in Orlando, Fla.
The competition offers first- and second-year
graduate students an educational experi-ence
to enhance their problem analysis and
presentation skills. Students are charged
with applying their creativity, knowledge and
experience to analyze real and diverse issues
facing a health care organization.
Ashley Winslow, Sadaf Houssain and
Matt Hasbrouck, graduate students in health
policy and management, were among the top
five teams at the University of Alabama at
Birmingham’s annual health care case com-petition
on Feb. 11, 2010. A total of 24 teams
participated in the competition.
Doctoral candidate Long among those
honored with UNC teaching awards
Dustin Long, doctoral candidate in bio-statistics,
has received a Tanner Award for
Excellence in Undergraduate Teaching by
a Graduate Assistant. The award, given
annually to five UNC
graduate assistants,
carries a $5,000
stipend.
Long was among
21 students and
faculty members who
received teaching
awards in January.
Phi Beta Kappa inducts
nine undergraduates from
UNC public health school
Nine of the 146 UNC under-graduates
inducted into
Phi Beta Kappa in fall 2009
hail from four public health
departments.
The students, all from
North Carolina, include
Kateland Elizabeth Branch,
Julia Vivian Loewenthal and
Patty Tian Wang (nutrition);
Bita Jasmine Emrani, Jared
Richard Lowe and Pranay Prabhakar (health
policy and management); Patrick Nathaniel
Healy and Andrew Parker Morgan (bio-statistics
and biology); and Rachel Parker
Stevens (environmental health science).
King, PHLP master’s student, wins Kuno
Research Award
Bradley King, a Master of Public Health stu-dent,
has received the Michiko Kuno Award
for Excellence in Student Research. The
award, presented Jan. 27 as part of the UNC
School of Medicine’s John B. Graham Medi-cal
Student Research Day, recognized King’s
research on diabetic retinopathy screening.
King is a health care and prevention
student in the public health school’s Public
Health Leadership Program and has com-pleted
his third year of medical school at UNC.
STAFF
NCIPH’s Place receives leadership award
Janet Place, direc-tor
of the Southeast
Public Health Train-ing
Center, part of
the N.C. Institute for
Public Health, has
received an award for
Best Leadership Proj-ect
at the Southeast
Public Health Lead-ership
Institute (SEPHLI) meeting, held in
Winston-Salem, N.C. Her project was titled
“Workforce Development Roadmap.”
ALUMNI
Alumnus Jenkins presented with APHA’s
Lilienfield Award for teaching excellence
Bill Jenkins, PhD,
MPH, received the
American Public
Health Associa-tion’s
2009 Abraham
Lilienfield Award,
which recognizes
excellence in the
teaching of epide-miology
during the
course of a career. An alumnus of the UNC
Gillings School of Global Public Health,
Jenkins is an affiliate of the UNC Institute
of African-American Research (www.unc.
edu/iaar) and co-director of UNC’s Minor-ity
Health Project. He previously had a
long, successful career at the U.S. Centers
for Disease Control and Prevention and at
the Center for Research on Health Dispari-ties
at Morehouse College in Atlanta.
N.C. INSTITUTE FOR
PUBLIC HEALTH
NCIPH honored for state service
The North Carolina Institute for Public
Health (NCIPH) received the N.C. Public
Health Association’s Partners in Public
Health Distinguished Group Award in
October 2009 at the Association’s 100th
anniversary meeting in Asheville.
The Institute, directed by Ed Baker, MD,
MPH, research professor in the Depart-ment
of Health Policy and Management,
celebrated its tenth anniversary in 2009,
highlighted by an event on Friday, Oct. 9.
The NCPHA award was established in
1998 to recognize organizations and profes-sions
that have made significant contribu-tions
to public health in North Carolina. n
awa r d s a n d r e co g n i t i o n s
Janet Place
Dr. Bill Jenkins
Dustin Long
(L-R) Presha Patel, Gregory Mascavage, Jessica Folmar
Details of these and other
awards are available at
www.sph.unc.edu/school/
recognitions.
c a r o l i n a p u b l i c h e a l t h | 33
Donor s
O U R D ON OR S
Supported by a $1.5 mil-lion
gift from Glaxo-
SmithKline, two of the School’s
researchers are teaming up
with N.C. Gov. Bev Perdue and
others to “eradicate cervical
cancer” in North Carolina—
the first step toward ending the
disease nationwide.
The Cervical Cancer-Free
Initiative, led by Noel Brewer,
PhD, assistant professor of
health behavior and health
education, and Jennifer S.
Smith, PhD, research associ-ate
professor of epidemiology,
will develop a plan for the state
based on evidence that cervi-cal
cancer can be prevented
through vaccines and effective
screening. Former North Caro-lina
State Health Director Leah
Devlin, DDS, who is a Gillings
Visiting Professor at the school,
is an adviser to the project.
At the outset, the initiative
aims to bring a coalition of
stakeholders together to iden-tify
opportunities for and bar-riers
to prevention, screening
and treatment. The research-ers
also will develop a project
to increase in-school
access to vaccines,
including the HPV
vaccine which pre-vents
infection with
the virus that causes
most cervical cancer.
The initiative also
will coordinate efforts
in California (via the
California Medical Associa-tion
Foundation), Alabama
and, eventually, other states.
Each state will build a coalition
of key stakeholders in cervical
cancer prevention, including
government, private, nonprofit
and community groups.
"North Carolina is a tre-mendous
leader in this multi-state
effort to end cervical
cancer," said Governor Perdue.
"Initiatives like this go hand-in-
hand with efforts such as
our state's investment in the
University Cancer Research
Fund, a historic commitment
to preventing and treating
cancer through innovative
medical research within our
world-class universities." n
–Natalie Gott
New cervical cancer initiative aims to save lives
Jack Allison, a 1966 UNC alumnus,
has composed "Dedication Song" to
honor the UNC public health school’s new
name as of September 2008—UNC Gillings
School of Global Public Health.
The song celebrates new possibilities
for growth at the School, thanks to Den-nis
and Joan Gillings' generous donation.
Allison began writing songs while
serving in the Peace Corps from 1967
to 1969, when he worked in a children’s
clinic in Nsiyaludzu, Nigeria. He had an
urge to see the world "outside the class-room"
after graduating from UNC with
a chemistry degree.
His songs contained lyrics with simple
lessons for new mothers, which, if fol-lowed,
would improve their babies' health.
Since his first efforts, Allison has
raised more than $150,000 in charity
through his music, establishing the Self
Help Foundation to manage funds gener-ated
by his songs.
When he heard about the School’s
name change, he took the initiative to
compose "Dedication Song" to commemo-rate
the occasion. Allison based the lyrics
on key words used to promote the School’s
goals, namely, anticipation, acceleration
and innovation.
A copy of the CD is avail-able
upon request to anyone who
makes a gift of $25 or more to the
School’s global health program.
For more information, contact
the School's Office of External
Affairs at (919) 966-0198. n
–Jay Cartwright
Allison composes song to celebrate School
Jack Allison and his wife, Sue
Wilson, are shown here with
friends in Nsiyaludzu, Malawi.
Dr. Noel Brewer Dr. Jennifer Smith
North Carolina is a tremendous leader in
this multi-state effort to end cervical cancer,
34 | SPRING 2 0 1 0
DONORS
Doctoral student Virginia
Senkomago, MPH, of
Uganda, received a Tellus Edu-cational
Foundation scholar-ship
to study infectious disease
epidemiology, particularly
sexually transmitted diseases
in sub-Saharan Africa.
Senkomago, who also
received The Winstanly Schol-arship,
funded by Derek and
Louise Winstanly, currently is
a research assistant on a proj-ect
led by Frieda Behets, PhD,
associate professor of epidemiol-ogy
at UNC Gillings School of
Global Public Health. Behets’
project focuses on sustainable
delivery of antiretroviral med-icine
to HIV patients in the
Democratic Republic of Congo
(DRC).
Senkomago is particularly
interested in HIV/AIDS in sub-
Saharan Africa because of the
toll it takes on individuals’ lives.
“Almost everyone I know in
Uganda has a friend or relative
affected by the disease,” Senk-omago
said.
Tellus Leadership Scholar-ships
worth up to $75,000 are
awarded to remarkable, com-mitted
students from tradi-tionally
underserved countries.
“Virginia’s proven academic
performance and her clinical
work in the DRC fit perfectly
with the Foundation’s goals,”
said Andrew Waters, president
of the Tellus Educational Foun-dation.
“We are thrilled that she
is a Tellus Leadership Scholar.”
“I want to use my knowledge
to enhance the well-being of
others,” Senkomago said. “The
Tellus scholarship allows me to
do this, and I’m so grateful for
the Foundation’s support.” n
–Natalie Gott
Bequests are a vital source of support for UNC Gillings
School of Global Public Health. Bequests:
• Create scholarships,
• Establish professorships,
• Build new facilities,
• Support research and
• Improve the public’s health.
The School’s continued excellence in research, teaching
and service depends upon you —our friends and alumni
who remember the School in their estate plans. Now —
more than ever —your bequest makes a difference.
Contact us today about including UNC Gillings School
of Global Public Health in your estate plans. For more
information, check the appropriate box in the enclosed
envelope, or contact:
Lyne S. Gamble Jr.
Director of Major and Planned Gifts
UNC Gillings School of Global Public Health
Campus Box 7407, 135 Dauer Dr.
Chapel Hill, N.C. 27599-7407
lyne_gamble@unc.edu
919.966.8368
Your Gift Today...
a healthier
tomorrow
Senkomago selected
for Tellus Educational
Foundation Scholarship
Virginia Senkomago
L inda Kastleman
L inda Kastleman
Master’s student Patsy Polston (right) is shown here with her
adviser, Dr. Jill Stewart.
c a r o l i n a p u b l i c h e a l t h | 35
Donor s
Pharmaceutical company sanofi-aventis is sponsoring a new
Department of Nutrition scholarship program that will help
bring top international doctoral students to UNC Gillings School
of Global Public Health.
Through the sanofi-aventis—UNC Global Nutrition Scholars
Program, the company will fund half the cost of a five-year doc-toral
program for three international students, or about $410,000.
The company’s sponsorship will be matched with funds from the
UNC Graduate School, the Department of Nutrition and faculty
funding sources.
“We’re trying to think more globally in our research and nutri-tion
programming,” said June Stevens, PhD, department chair. “This
is a great step forward in accomplishing that goal.”
Stevens says that the economic downturn has meant many quali-fied
and enthusiastic international students have not been able to
attend UNC. The scholarship will make that opportunity possible
and will prepare more students to address nutrition and other health
challenges around the world.
The first Scholars will arrive at UNC in fall 2010. After their
first year of study, they will have the unique opportunity to develop
skills and broaden their understanding of the global pharmaceutical
industry through an internship with sanofi-aventis U.S. n
More than 300 alumni
and friends of UNC’s
biostatistics department came
to Chapel Hill, N.C., on Oct.
12, 2009, to celebrate the
department’s 60th anniversary.
A series of presentations
illuminated the department’s
distinguished history, and
attendees from as far away as
Brazil shared remembrances
about their experiences in
Chapel Hill. The multiple-day
event was a happy mix of schol-arship
and friendship.
“A key theme that emerged
in our celebrations and presen-tations
was the invaluable role
of the student-mentor relation-ship,”
said Michael Kosorok,
PhD, professor and chair in the
department.
“We were all moved at
how many of these relation-ships
stay vibrant and alive,
beyond campus walls and past
graduation.”
A fitting emblem of that
phenomenon, Kosorok said,
is Gary Koch, PhD, whose
Festschrift* was a highlight
of the celebration. Colleagues
and former students presented
lectures and testimonials to
honor the longtime professor’s
achievements. A special issue
of the journal Statistics in Bio-pharmaceutical
Research, to
appear in late 2010 or 2011,
will include scientific articles
honoring Koch.
One of the celebratory
events was a breakfast for Law-rence
Kupper, PhD, Alumni
Distinguished Professor of bio-statistics,
who retires in 2010
after 40 years on the UNC
faculty.
The department was estab-lished
in 1949, under the
leadership of inaugural chair
Bernard Greenberg, PhD.
Greenberg chaired the depart-ment
until he became dean of
the UNC public health school
in 1972.
A gallery of photogra